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AN  EPITOME 


TRIPLER'S  MANUAL, 


AND 


OTHER  PUBLICATIONS 


ON   THE 


EXAMINATION  OF  RECRUITS. 


BY 


CHAS.  R.  GREENLEAF, 

Major  and  Surgeon,  U.  S.  A. 


WASHINGTON,  D.  C. : 

WILLIAM  BALLANTYNE  &  SONS. 

1890. 


^^■^' 


x^ 


Entered  according  to  Act  of  Congress  in  the  year  1S90,  by 
Charles  R.  Greeni^eaf. 


JUDD  &.  DETWEILER, 

PRINTERS, 

WASHINGTON,   D.  C. 


The  following  epitome  of  Tripler's  Manual  is  intended 
for  the  guidance  and  use  of  Recruiting  Officers  in  the  exam^_ 
ination  of  applicants  for  enlistment  into  the  United  States 
Army. 

The  Manual,  written  principally  for  the  use  of  Medical 
Officers,  contains  much  that  is  useless  or  incomprehensible 
to  the  non-professional  man  by  reason  of  its  technicalities, 
and  as  Recruiting  Officers  are  frequently  required  to  examine 
applicants  without  the  assistance  of  a  medical  officer,  it  is 
believed  that  a  more  useful  guide  can  be  made  by  eliminat- 
ing this  material,  and  omitting  all  referenoe  to  the  subjects 
of  malingering,  discharges  from  service,  etc. 

Advantage  has  been  takfen  of  this  opportunity  to  add  such 
new  instructions,  as  time  and  experience  have  shown  to  be 
necessary,  since  the  original  publication  of  the  Manual. 

Columbus  Barracks,  Ohio,  June^  188i.. 

Headquarters  of  the  Army, 

Adjutant  General's  Office, 

Washington,  June  10,  I884.. 
This  epitome  of  Tripler's  Manual,  prepared  by  Major 
Charles  R.  Greenleaf,  Surgeon,  U.  S.  Army,  is  published 
for  the  information  and  guidance  of  recruiting  officers  in 
the  examination  of  applicants  for  enlistment  into  the  United 
States  Army. 

By  command  op  Lieut.  Gen'l  Sheridan: 

R.  C.  DRUM, 
Adjutant  General. 

(3) 


Since  the  publication  of  the  epitome  of  Tripler's  Manual 
much  has  been  written  on  the  general  subject  of  physical 
examinations,  and  many  changes  in  the  methods  of  exam- 
ining recruits  have  been  announced  in  orders  from  the  War 
Department  and  the  Headquarters  of  the  Eecruiting  Service. 
In  the  following  epitome  this  information  is  incorporated  ; 
the  application  of  the  vision  test  is  explained  ;  the  instruc- 
tions for  chest  measurements  are  revised;  new  material 
suggested  by  the  experience  of  the  past  few  years  has  been 
added,  and  errors,  typographical  and  otherwise,  have  been 
corrected. 

Washington,  D.  C,  April  10,  1890. 

War  Department, 
Adjutant  General's  Oefice,    ^ 
Washington,  April  10,  1890. 
Approved  : 

By  order  of  the  Secretary  of  War. 

J.  C.  KELTON, 

Adjutant  General. 


(5) 


THE  PHYSICAL  EXAMINATION  OF  RECRUITS. 


LEGAL    REQUIREMENTS. 

.  Any  male  person  above  the  age  of  sixteen  and  under  the  age 
of  thirty-five  years,  effective,  able-bodied,  and  free  from  disease, 
of  good  character,  who  does  not  appear  to  be  of  intemperate 
habits,  and  who  has  a  competent  knowledge  of  the  English 
language,  may  be  enlisted,  due  attention  being  given  to  the 
restrictions  in  this  article  concerning  minors.  This  regula- 
tion, in  so  far  as  it  relates  to  age,  shall  not  apply  to  soldiers 
who  may  re-enlist  nor  to  those  who  have  served  honestly 
and  faithfully  a  previous  enlistment  in  the  Army.  Appli- 
cants for  enlistment  will  be  required  to  furnish  such  evidence 
of  good  character  as  they  can  obtain.  With  a  view  to  de- 
termine their  fitness  and  aptitude  for  the  service  and  to  give 
them  an  opportunity  to  secure  testimonials,  as  well  as  for 
the  inquiry  and  deliberation  contemplated  by  the  2d  Article 
of  War,  they  may  be  retained  and  provided  for  at  rendezvous, 
after  having  signed  the  declaration  of  intention  to  enlist  and 
passed  the  medical  examination,  for  not  to  exceed  six  days. 
Men  so  retained  will  be  known  as  recruits  on  probation.  The 
enlistment  papers  of  any  such  recruit  who  may  be  unfit  or 
undesirable  for  the  service  or  who  may  not  desire  to  remain 
in  the  service  will  not  be  completed.  The  enlistment  papers 
of  recruits  who  are  accepted  and  duly  sworn  will  bear  the 
date  on  which  the  enlistment  is  completed  by  administering 
the  oath.     (A.  R.  Art.  LXXI,  908.) 

*         *         *         *  The  Major  General  Commanding 

the  Army  is  of  opinion  that  if  satisfactory  evidence  of  good 
character,  habits,  and  condition  cannot  be  furnished  by  the 
recruit  or  be  otherwise  obtained,  the  presumption  should  be 
against  him  and  he  should  not  be  accepted  ;  and,  further, 
that  these  views  are  concurred  in  by  the  Secretary  of  War 

(7) 


8 

and  should  govern  in  all  cases.     (G.  0.  No.  1,  Headquarters 
Recruiting  Service,  1890.) 

Art.  2.  These  rules  and  articles  shall  be  read  to  every 
enlisted  man  at  the  time  of  or  within  six  days  after  his  en^ 
listment,  and  he  shall  thereupon  take  an  oath  or  affirmation 
in  the  following  form  :  "I,  A.  B.,  do  solemnly  swear  (or 
affirm)  that  I  will  bear  true  faith  and  allegiance  to  the  United 
States  of  America ;  that  I  will  serve  them  honestly  and  faith- 
fully against  all  their  enemies  whomsoever,  and  that  I  will 
obey  the  orders  of  the  President  of  the  United  States  and  the 
orders  of  the  officers  appointed  over  me,  according  to  the 
rules  and  articles  of  war."  This  oath  may  be  taken  before 
any  commissioned  officer  of  the  Army.     (Article  of  War.) 

Art.  3.  Every  officer  who  knowingly  enlists  or  musters 
into  the  military  service  any  minor  over  the  age  of  sixteen 
years  without  the  written  consent  of  his  parents  or  guardians 
or  any  minor  under  the  age  of  sixteen,  or  any  insane  or  in- 
toxicated persons,  or  any  deserter  from  the  military  or  naval 
service  of  the  United  States,  or  any  person  who  has  been 
convicted  of  .any  infamous  criminal  offense  shall,  upon  con- 
viction, be  dismissed  from  the  service,  or  suffer  such  other 
punishment  as  a  court  martial  may  direct.    (Article  of  War.) 

The  regulations  above  quoted  sketch  in  outline  the  re- 
quirements for  admission  to  the  enlisted  branch  of  the 
military  service  and  the  duties  of  officers  in  connection 
therewith.  For  the  recruiting  officer  an  essential  to  success 
is  a  knowledge  of  men  and  their  character,  and  for  the  medical 
officer,  a  painstaking  application  of  professional  skill.  The 
duty  is  a  most  important  one,  and  in  its  faithful  and 
thorough  performance  these  officers  share  a  grave  responsi- 
bility. The  influence  of  their  judgment  and  discretion  is  felt 
throughout  the  entire  military  establishment,  the  efficiency 
of  which  depends  in  great  measure  upon  the  sound  mental 
and  physical  condition  and  the  intelligence  of  its  enlisted 
force.  From  the  varied  classes  and  conditions  of  men  pre- 
senting themselves  for  enlistment  they  are  to  eliminate  not 


9 

only  those  who  are  defective  physically  and  mentally  but 
those  who  are  defective  morally,  and  if  this  duty  be  per- 
formed carelessly  or  indifferently;- men  will  be  admitted  to 
the  service  with  defects  which  will  soon  render  them  unfit  for 
duty,  or  with  moral  obliquities  that  will  induce  malingering 
and  desertion.  Although  the  result  of  such  perfunctory  per- 
formance of  duty  may  come  to  light  during  the  probationary 
service  of  a  recruit  at  a  depot,  it  will  certainly  be  shown  in 
the  company,  from  which  his  eventual  discharge  cannot  fail 
to  bring  deserved  censure  upon  the  officers  concerned  in  his 
enlistment. 

The  examination  of  men  for  enlistment  may,  in  general 
terms,  be  divided  into  the  physical,  the  intellectual,  and 
the  moral.  In  the  emergencies  which  our  troops  are  called 
upon  to  meet,  where  celerity  of  movement  and  ability  to  en- 
dure privations  and  hardships  are  indispensable  to  success, 
the  necessity  for  able-bodied  men  is  obvious,  and  a  detailed 
description  of  the  methods  to  be  employed  in  their  physical 
examination  will  be  given  further  on.  Intellectually,  although 
no  educational  standard  is  officially  established,  a  soldier 
should  be  able  to  read  and  write,  and  should  also  be  quick 
and  clear  in  his  understanding.  The  advance  in  the 
science  and  art  of  war  and  the  improvement  in  modern 
fire-arms  calls  for  a  higher  degree  of  intelHgence  than  was 
required  of  the  soldier  in  the  past.  This  is  recognized  by  the 
Government  by  the  establishment  of  schools  and  libraries, 
by  providing  reading-rooms  that  are  liberally  supplied  with 
periodicals  and  newspapers,  and  by  opening  the  way  for 
promotion  to  all  who  avail  themselves  of  these  opportunities 
for  advancement.  The  care  and  attention  that  the  soldier 
is  required  to  give  to  his  weapon  and  ammunition,  the  drill 
which  its  use  entails,  and  the  skill  which  may  be  attained 
by  the  practice  of  rifle  firing  develop  individuality,  excite 
interest  and  ambition,  and  tend  to  make  the  profession  at- 
tractive. It  is  therefore  desirable  that  men  should  be  se- 
lected who  can  appreciate  this  life  and  who  have  the  mental 
2 


10 

capacity  to  profit  by  it.  The  moral  character  should  be 
scrutinized  with  care  in  order  that  enlistments  from  the 
vagrant  and  criminal  classes  may  be  avoided.  The  reSruit^ 
ing  rendezvous  is  a  favorite  haunt  for  these  men  and  a  study 
of  their  personal  characteristics  will  well  repay  the  recruit- 
ing officer  for  his  labor.  The  vagrant  seeks  admission  to 
the  Army,  usually  at  the  beginning  of  winter,  for  shelter, 
food,  and  clothing,  without  any  intention  of  completing  his 
enlistment  or  of  performing  any  more  service  than  he  is 
compelled.  The  criminal  seeks  to  bury  his  unsavory  history 
under  an  assumed  name,  and,  by  service  in  distant  stations, 
to  escape  the  observation  of  those  who  know  him.  The  evil 
influence  in  a  company  of  even  one  of  this  class  cannot  be 
overestimated,  and  no  degree  of  physical  perfection  or 
soldierly  bearing  should  induce  a  recruiting  officer  to  accept 
his  service.  Happily,  as  a  rule,  the  evidence  of  a  life  of 
debauchery  is  so  plainly  marked  in  the  features  and  in  the 
person  that  an  ordinary  observer  is  able  to  estimate  the  true 
character  of  such  an  applicant  without  difficulty. 

.The  enlistment  of  recruits  is  made  upon  the  concurrent 
action  of  the  recruiting  and  medical  officer,  the  former  being 
responsible  for  the  general  fitness,  aptitude,  and  character  of 
the  applicant ;  the  latter  for  his  physical  and  mental  con- 
dition. At  this  examination  the  recruiting  officer  is  required 
to  be  present. 

The  exigencies  of  the  service,  however,  render  occasionally 
the  presence  of  a  medical  officer  at  an  enlistment  impracti- 
cable. In  that  event,  the  recruiting  officer  is  directed  to  "make 
the  required  examination,"  and  the  medical  inspection  is 
subsequently  provided  for  at  a  depot,  if  the  recruit  is  en- 
listed in  the  General  Service,  or  at  the  nearest  military  post 
if  he  has  been  enlisted  elsewhere.  At  the  former  station  he 
is  examined  by  the  Depot  Surgeon  within  two  days  after 
arrival,  and  if  disqualifying  defects  are  discovered  is  dis- 
charged the  service  on  Certificate  of  Disability.  Similar 
action  is  taken  at  military  posts  under  like  circumstances. 


11 


THE   GENERAL   EXAMINATION. 

Tbe  Army  Regulations  of  1881  directed  that  "in  passing 
a  recruit  the  examining  officer  is  to  examine  him  stripped; 
to  see  that  he  has  the  free  use  of  his  limbs ;  that  his  chest 
is  ample ;  that  his  hearing,  vision,  and  speech  are  perfect ; 
that  he  has  no  tumors  or  ulcerated  or  extensively  cicatrized 
legs  ;  no  rupture  or  chronic  cutaneous  affection ;  that  he  has 
not  received  any  contusion  or  wound  of  the  head ,  that  may 
impair  his  faculties  ;  that  he  is  not  a  drunkard ;  is  not  sub- 
ject to  convulsions,  and  has  no  infectious  or  other  disorder 
that  may  unfit  him  for  military  service ; "  also  that  the 
recruit  must  be  effective,  able-bodied,  sober,  free  from  disease, 
and  of  good  character  and  habits. 

The  leading  characteristics  of  a  good  constitution  are  thus 
enumerated  by  Tripler :  "  A  tolerably  just  proportion  be- 
tween the  different  parts  of  the  trunk  and  members  ;  a  well- 
shaped  head,  thick  hair,  a  countenance  expressive  of  health, 
with  a  lively  e/e,  skin  not  too  white,  lips  red,  teeth  white 
and  in  good  cc»ndition,  voice  strong,  skin  firm,  chest  well 
formed,  belly  lank,  parts  of  generation  well  developed,  limbs 
muscular,  feet  arched  and  of  a  moderate  length,  hands  large. 
The  gait  should  be  sprightly  and  springy,  speech  prompt 
and  clear,  and  manner  cheerful.  All  lank,  slight,  puny 
men,  with  contracted  figures,  whose  development  is,  as  it 
were,  arrested,  should  be  set  aside.  The  reverse  of  the  char- 
acteristics of  a  good  constitution  will  indicate  infirm  health 
or  a  weakly  habit  of  body ;  loose,  flabby,  white  skin ;  long 
cylindrical  neck  ;  long,  flat  feet ;  very  fair  complexion,  fine 
hair ;  wan,  sallow  countenance,"  etc. 

"  The  enlistment  of  *  *  intoxicated  persons  *  "^  is 
forbidden  "  [A.  R.  909].  This  regulation  is  intended  not 
only  to  prevent  the  admission  to  the  service  of  men  who  at 
the  time  of  enlistment  are  under  the  influence  of  stimulants 
or  narcotics,  but  of  those  who  are  of  intemperate  habits. 


12 

Popular  opinion  regards  the  discipline  of  the  Army  as  a 
wholesome  restraint  upon,  if  not  a  curative  agent  for,  in- 
ebriates, and  no  small  number  of  men  are  applicants  for 
enlistment  with  that  end  in  view.  Some  officers  are  inclined^ 
to  look  leniently  upon  a  history  of  accidental  departures 
from  a  life  of  sobriety,  or  to  condone  a  debauch  immediately 
preceding  an  application  for  enlistment.  The  evils  of  in- 
temperance, however,  particularly  among  soldiers,  are  so 
great  that  the  interests  of  the  service  imperatively  demand 
a  rigid  exclusion  of  men  whose  habits  in  this  respect  are 
under  suspicion,  and  a  recruiting  officer  would  be  perfectly 
justified  in  going  even  so  far  as  to  reject  men  upon  whom 
the  smell  of  liquor  was  perceptible.  The  suggestion  of 
Tripler  to  "  Suspend  a  final  decision  for  a  sufficient  length 
of  time  to  enable  a  man  to  recover  from  the  effects  of  a  mere 
temporary  debauch"  meets  with  no  favor  in  the  present  day. 
A  thorough  inquiry  should  be  made  into  the  history  of  any 
case  in  which  habits  of  intemperance  are  suspected,  and  al- 
though the  examiner  may  meet  with  difficulty  in  forming 
a  just  opinion  from  such  statements  as  the  applicant  may  be 
willing  to  make  about  himself,  the  "  long  indulgence  in 
habits  of  intemperance  will  almost  surely  be  indicated  by 
persistent  redness  of  the  eyes,  tremulousness  of  the  hands, 
attenuation  of  the  muscles — particularly  of  the  lower  ex- 
tremities— sluggishness  of  the  intellect,  an  eruption  upon 
the  face,  and  purple  blotches  upon  the  legs.  Close  and 
skillful  questioning  will  often  develop  the  facts  connected 
with  the  antecedents  of  the  applicant,  and  materially  assist 
the  examiner  in  forming  his  opinion  of  the  case." 

The  only  disqualification  incident  to  the  birthplace  of  the 
recruit  is  the  want  of  competent  knowledge  of  the  English  lan- 
guage. "  Competent  knowledge  "  is  defined  by  the  War  De- 
partment as  the  ability  of  the  applicant  to  converse  intelli- 
gently and  fully  understand  the  orders  and  instructions 
given  in  that  language. 

In  a  population  having  so  considerable  a  percentage  of 


13 

foreigners  as  is  found  in  our  country  it  is  not  surprising  that 
many  who  are  ignorant  of  the  English  language  should 
apply  for  enlistment.  Inexperienced  recruiting  officers,  mis- , 
led  by  the  fine  personal  appearance  of  such  men,  or  by  testi- 
monials as  to  their  skill  in  various  handicrafts,  may  be  in- 
duced to  enlist  them,  hopmg  that  their  defects  will  be  over- 
come after  association  with  English-speaking  men.  The 
results,  however,  seldom  justify  their  expectations ;  the  soldier 
soon  becomes  inefficient,  and  ip  finally  discharged  from  the 
service  because  of  his  inability  to  understand  his  instruc- 
tions. • 

Some  relaxation  of  this  rule  may  be  made  in  the  cases  of 
skilled  artisans,  tailors  and  band  musicians  being  particu- 
larly desirable. 

In  time  of  war  familiarity  w4th  the  language  is  not  so 
necessary,  as  foreigners  are  more  likely  to  be  assigned  to 
regiments  made  up  of  their  own  countrymen,  with  officers 
who  speak  their  language.  The}^  can  also  be  made  useful 
in  the  administrative  departments  of  the  Army,  taking  the 
places  of  men  better  fitted  for  field  service.^ 

The  recruiting  officer  will  seldom  err  in  these  general 
matters  if  he  decline  to  enlist  any  man  whom  he  would  not 
be  willing  to  have  as  a  member  of  his  own  company. 

RE-ENLISTMENTS. 

The  recruiting  officer  is  permitted  to  accept  men  desiring 
to  re-enlist  and  who  present  themselves  for  that  purpose 
within  the  prescribed  limit,  "notwithstanding  they  may 
have  some  physical  disqualification  which  would  cause  their 
rejection  as  recruits,  provided  they  have  no  serious  defect 
which  would  probably  prevent  the  discharge  of  their  duties 
as  soldiers." 

"  In  all  such  cases  the  defects  and"  the  fact  that  the}^  ex- 
isted prior  to  re-enlistment  will  be  noted  on  the  soldier's 
enlistment  papers." 


14 

In  modifying  its  requirements  for  enlistment  in  this  par- 
ticular, it  is  the  intention  of  the  War  Department  to  provide 
for  the  continuance  in  service  of  such  faithful  soldiers  as 
have  incurred  disabilities  during  prior  enlistments,  which 
either  do  not  or  probably  will  not  unfit  them  for  duty  in  the 
future,  as,  for  example,  hernia,  which  is  kept  in  place  by 
wearing  a  truss ;  piles ;  varicose  veins ;  certain  defects  of 
vision,  as  near  or  far  sight ;  the  loss  of  certain  fingers  and 
toes ;  mutilations  by  gunshot  or  other  wounds,  etc. 

"  Serious  defects  "  may  be  defined  as  those  which  cause 
either  an  incapacity  for  duty  at  present  or  are  likely  to  do 
so  in  the  future,  such  as  total  blindness  of  the  right  eye ; 
amputation  of  an  entire  member,  hand  or  foot,  or  any  con- 
stitutional disease,  as  syphilis,  etc. 

MODE  OF   EXAMINING  A  RECRUIT. 

The  room  in  which  the  examination  is  conducted  should 
be  well  lighted  and  large  enough  for  the  men  to  exercise  in 
walking,  running,  and  jumping,  as  every  organ  directly  con- 
cerned in  locomotion  should  be  subjected  to  inspection. 
Only  those  persons  who  are  absolutely  required  should  be 
present  at  the  examination. 

The  person  of  the  recruit  should  be  washed  with  soap 
and  water  before  he  is  presented  for  inspection.  "  It  is  not, 
however,  believed  to  be  good  policy  to  enlist  men  who, 
though  able-bodied  and  intelligent,  appear  at  recruiting 
rendezvous  in  ragged  or  filthy  dress,  as  the  chances  are  such 
men  are  tramps  and  vagabonds  and  will  not  make  good 
soldiers.  Men  who,  though  attired  in  clean  and  respectable 
clothing,  are  found  to  be  filthy  in  their  persons  should  be 
promptly  rejected  for  like  reason."  (Cir.  No.  19,  Headquarters 
Recruiting  Service,  1889.) 

Thoroughness  in  the  preliminary  examination  is  assured 
by  a  methodical  inquiry  into  the  family  and  personal  history 
of  the  applicant,  whose  replies  should  be  recorded  at  the  time. 


15 

For  this  purpose  a  printed  Form  is  furnished  by  the  Adjutant 
General  of  the  Army,  to  be  used  by  recruiting  officers  where 
there  is  no  medical  examiner.  This  also  serves  as  evidence, 
should  the  recruit  allege  unfitness  from  a  defect  that  is 
feigned,  or  be  subsequently  found  unfitted  for  duty  on  ac- 
count of  one  which  has  been  concealed. 

It  should  be  understood  that  the  questions  in  this  Form 
are  intended  simply  as  the  guide  to  a  careful  and  searching 
examination  into  the  physical  history  of  the  applicant  for 
enlistment.  If  his  replies  suggest  the  existence  of  any  in- 
firmity or  defect,  special  inquiry  should  be  made  concerning 
it  in  order  that  the  most  complete  information  may  be 
elicited. 

He  who  is  satisfied  with  "a  simple  negative  or  affirmative 
reply  to  the  queries  propounded  in  the  Form  will  often  fail 
to  discharge  efficiently  the  duty  he  is  called  upon  to  perform. 

The  questions,  and  any  others  necessary  to  develop  his 
fitness  for  the  duties  of  a  soldier,  should  be  asked  and  the 
man's  answers  recorded  before  he  is  stripped,  after  which 
the  examination  is  proceeded  with. 

Applicants  for  enlistment  who  are  unacceptable  to  the 
recruiting  officer  before  being  examined  physically  need  not 
be  accounted  for  on  the  Medical  Forms,  but  a  record  must 
be  made  of  the  height,  weight,  and  chest  measures,  the  com- 
plexion, and  the  color  of  hair  and  eyes  of  every  man  whose 
physical  examination  has  been  commenced.  This  exami- 
nation may  stop  at  any  time,  where  a  positive  disqualifica- 
tion is  discovered,  note  being  made  on  the  Form  of  the  fact 
and  its  cause.  If  insufficient  chest  capacity  or  lack  of  weight 
is  suspected,  that  part  of  the  examination  may  be  conducted 
before  questioning. 

The  second  question  on  the  Form  relates  particularly  to 
the  diseases  of  childhood,  such  as  measles,  scarlet  fever,  etc. 

The  degree  of  knowledge  of  the  English  language  is  to  be 
recorded  as  "  good,"  "  fair,"  "  limited,"  or  otherwise,  bearing 
in  mind  the  definition  of  "  competent  knowledge  "  as  given 


16 

herein,  and  the  "  figure  and  general  appearance  "  is  to  be 
noted  as  "  soldierly,"  "  good,"  "  poor,"  or  otherwise. 

Each  peculiarity  or  particular  deviation  from  the  normal_^ 
standard  in  a  given  region  is  to  be  noted.     See  "  scars,  marks, 
etc." 

If  a  careful  inspection  is  made  and  a  defect  noted,  which 
upon  due  consideration  is  not  considered  by  the  officer  mak- 
ing the  examination  to  be  disqualifying,  he  is  relieved  from 
responsibility ;  but  if  he  passes  a  recruit  who  has  a  serious 
defect,  which  is  discernible  by  an  ordinary  layman,  and  enlists 
the  man  without  noting  the  defect  upon  the  examination  form 
and  the  enlistment  papers  it  evidences  neglect  in  the  exam- 
ination.    (A.  G.,  Oct.  26,  1886.), 

Before  recruits  leave  the  rendezvous  for  the  depot  they 
should  be  carefully  re-examined  and  a  statement  to  that 
effect  made  on  the  form,  with  a  note  descriptive  of  any  de- 
fect which  may  have  been  discovered  or  contracted  since  the 
enlistment. 

The  Form  when  filled  up  should  be  sent  with  the  recruit 
to  the  depot  when  he  is  enlisted  in  the  General  Service,  or  be 
deposited  with  the  regimental  records  when  he  is  enlisted  in 
a  particular  regiment,  thereto  be  retained  six  months,  or  as 
much  longer  as  may  be  necessary  to  serve  its  purpose,  when 
it  is  to  be  forwarded  to  the  Surgeon  General  of  the  Army. 


FORM  FOR  THE  PHYSICAL  EXAMINATION  OF   A  RECRUIT. 


^ 


Name ;  Age ;  Occupation ; 

Birthplace ;  Kesidence ;  Height*^ ; 

Weight--^ ;  Chest  measurement:  Expiration ;  Inspiration ;_ 

e     Nationality  of  father ;  Of  mother ; 

-^     Have   you  applied  for  enlistment  at  any  other  rendezvous;    and  if   so, 

.§  where? 

1^    What  sickness  have  you  had,  and  at  what  age? 

■^     Are  both  parents  living? 

I     If  either  has  died,  state  cause  ; 

^     If  brother  or  sister  has  died,  state  cause; 

^     Have  you  given  up  any  occupation  on  account  of  your  health  or  habits  ? 

0  1 

1  Are  you  subject  to  dizziness? ;  to  severe  headache? : 

1  to  pain  in  the  breast? ;  to  fluttering  of  the  heart  ? . ;  to 

shortness  of  breath ? ;  to  colds  in  the  head? ;  to  coughs? 

;  to  diarrhoea? ;  to  piles  ? ;  to  rheumatism  ? 

1^    Do  you  believe  you  are  sound  and  well  now? 

e     Have  you  had  sore  eyes? 

^     Have  you  had  running  from  either  ear? 

■''     Have  you  had  fits  ?     If  so,  how  frequently  ? 

S     Do  you  have  any  diflSculty  in  making  or  holding  your  water  ? 

2  Have  vou  had  stricture  ? 

"^     Have  you  had  gonorrhoea,  and  when? 

.     Have  you  had  a  sore  of  any  kind  upon  your  penis,  and  when? 

,|     Have  you  had  any  swelling  about  or  of  your  testicles? 

_§;    Have  you  had  a  boil  near  the  anus  (fistula)? 

•^     Have  you  been  ruptured? 

^     Do  you  drink  intoxicating  liquors?     If  so,  to  what  extent? 

"5^    Have  you  had  the  "  horrors,"  and  when? 

"^     Have  you  been  hurt  upon  the  head?     Answer  fully 

J     Have  you  had  a  sprain ? ;  a  stiff  joint? ;  a  bone  or 

^  joint  out  of  place? ;  a  bone  broken? 

in    Are  you  subject  to  sore  feet? 

I     Mention  carefully  any  other  injuries  or  any  surgical  operation  you  may 
^  have   had   in  any  part  of  your  body,  especially  burns,  cuts,  severe 

=0  bruises,  &c 

fHave  you  any  one  dependent  upon  you  for  support? 

Have  you  ever  been  convicted  of  a  felony,  or  been  imprisoned  in  a  jail  or 
penitentiary  ? 

*  Note  height  and  weight  stripped,  unless  rejected  for  some  absolute  disqualification  in 
preliminary  examination. 

flf  answered  in  affirmative,  recruiting  officer  before  accepting  applicant  should  endeavor 
to  satisfy  himself  that  there  is  no  probabilitv  of  application  being  made  for  the  man's  dis- 
charge on  this  account. 

3  (17) 


18 


When  stripped,  examine  carefully  the  head,  ears,  eyes  (including  color- 
blindness and  astigmatism*),  nose,  mouth  (especially  teeth,  hard  palate, 
and  tonsils),  neck  (especially  for  enlarged  glands) ;  chest:  shape  (flat  or 
pigeon-breasted),  resonance,*  character  of  respiration  ;*  heart:  sounds,*" 
impulse*  (position  and  force),  action*  (as  to  regularity)  ;  spine  ;  abdomen 
(especially  for  hernia  and  enlarged  glands  in  the  groin)  ;  genito-urinary 
apparatus ;  anus  (especially  for  fistula)  ;  upper  extremities  (especially  for 
enlarged  glands  at  the  elbows) ;  lower  extremities  ;  skin. 


"ft 


01.2:  o-^ 

<i> «-  §  2 


Knowledge  of  the  English  language 
Previous  service  (U.  S.  or  foreign)  __ 

Comparative  intelligence 

Figure  and  general  appearance 

Remarks 


I  certify  that  I  have  asked  the  foregoing  questions  and  have 
recorded  the  answers  as  given  to  me,  and  have  personally  examined 
the  above-named  recruit. 


Place 

Date. 


Examining  Officer. 


NoTK. — This  paper,  with  defects  discovered  at  depot,  noted  and  signed    by  the  medical 
officer,  to  accompany  the  proceedings  of  boards  of  inspection  in  the  case  of  rejected  recruits. 


*  Especially  for  medical  examiner. 


19 

[Indorsement  on  the  back  of  the  Form.] 


Recruit 

Examination  of 

enlisted  at      ,                        , 

BY 

Recruiting  Officer. 

This  recruit  has  been 
the  rendezvous  for  the 

re-examined  before  leaving 
depot  and  found  to  be— 

Becraiting  Officer. 
Date,: 18       . 

Remarks  of  the  Medical  Officer  at  the  Depot. 


Surgeon,  U.  S.  A. 
Date 18       . 


20 


ORDER  OF  EXAMINATION. 

Let  the  recruit  take  the  position  of  a  soldier  in  the  best- 
lighted  part  of  the  room ;  then  examine  him  in  the  follow- 
ing order  after  the  methods  elsewhere  set  forth : 

The  duties  of  the  inspecting  officer  will  here  be  materially 
facilitated  if  he  instruct  the  recruiting  sergeant  in  the  posi- 
tions of  the  examination,  as  the  recruit  will  usually  find  no 
difficulty  in  imitating  the  movements  of  the  non-commis- 
sioned officer. 

1.  Inspect  general  physique,  skin,  scalp  and  cranium, 
ears,  eyes,  nose,  mouth,  face,  neck,  and  chest,  and  take  the 
chest  measurements. 

2.  The  arms  should  be  extended  above  the  head,  the  backs 
of  the  hands  being  together,  and  the  applicant  required  to 
cough  vigorously ;  any  form  of  rupture  may  now  be  dis- 
covered by  the  hand  and  eye. 

3.  The  hands  remaining  extended  above  the  head,  the 
man  should  be  required  to  take  a  long  step  forward  with  the 
right  foot  and  bend  the  right  knee;  the  genital  organs  are 
conveniently  exposed  and  varicocele  or  other  defects  in  the 
scrotum  may  be  recognized. 

4.  Arms  down,  and  the  man  required  to  separate  the  but- 
tocks with  his  hands,  at  the  same  time  bending  forward ;  this 
exposes  the  anus. 

5.  Examine  the  heart  and  lungs.* 

6.  The  elbows  should  be  brought  firmly  to  the  sides  of  the 
body  and  the  fore  arms  extended  to  the  front,  palms  of  the 
hands  uppermost ;  extend  and  flex  each  finger  separately ; 
bring  the  points  of  the  thumbs  to  the  base  of  the  little  fingers ; 
close  the  hands,  with  the  thumb  covering  the  fingers ;  extend 
and  flex  the  hands  on  the  wrists  ;  rotate  the  hands  so  that  the 
finger  nails  will  first  be  up  and  then  down ;  move  the  hand 


*  Especially  for  Medical  Examiner. 


21 

from  side  to  side ;  extend  the  arms  and  fore  arms  fully  to 
the  front  and  rotate  them  at  the  shoulder ;  flex  the  fore  arms 
on  the  arms  sharply,  striking  the  shoulders  with  the  fists^  ^ 
extend  the  arms  at  right  angles  with  the  body,  place  the 
thumbs  on  the  points  of  the  shoulders,  raise  and  lower  the 
arms,  bringing  them  sharply  to  the  side  at  each  motion ;  * 
let  the  arms  hang  loosely  by  the  side ;  swing  the  right  arm 
in  a  circle  rapidly  from  the  shoulder,  first  to  the  front  and 
then  to  the  rear ;  swing  the  left  arm  in  the  same  manner  ; 
extend  the  arms  fully  to  the  front,  keeping  the  palms  of  the 
hands  together  and  thumbs  up  ;  carry  the  arms  quickly  back 
as  far  as  possible,  keeping  the  thumbs  up,  and  at  the  same 
time  raise  the  body  on  the  toes  ;  extend  the  arms  above  the 
head,  locking  the  thumbs,  and  bend  over  to  touch  the  ground 
with  the  hands,  keeping  the  knees  straight. 

7.  Extend  one  leg.  lifting  the  heel  from  the  floor,  and  move 
all  the  toes  freely ;  then  move  the  foot  up  and  down  and 
from  side  to  side,  bending  the  ankle  joint,  the  knee  being- 
kept  rigid ;  bend  the  knee  freely ;  kick  forcibl}^  backward 
and  forward  and  then  throw  the  leg  out  to  the  sides  as  far 
as  possible,  keeping  the  body  squarely  to  the  front ;  repeat 
these  motions  with  the  other  foot  and  leg ;  strike  the  breast 
first  with  one  knee  and  then  with  the  other  ;  stand  upon  the 
toes  of  both  feet ;  squat  sharply  several  times ;  kneel  upon 
both  knees  at  the  same  time  (if  the  man  comes  down  on  one 
knee  after  the  other  there  is  reason  to  suspect  infirmity). 
Take  the  position  to  "  fire  kneeling  ;  "  present  the  back  to 
the  examiner  and  then  hold  up  to  view  the  sole  o^  each  foot ; 
leap  directly  up,  striking  the  buttocks  with  the  heels ;  hop 
the  length  of  the  room  on  the  ball  of  first  one  foot  and  then 
the  other  ;  make  a  standing  jump  as  far  as  possible  and  re- 

*  It  may  be  here  observed  that  in  a  few  instances  the  recruit  cannot  touch  his  shoul- 
ders with  his  fingers,  and  siill  the  most  rigid  examination  could  detect  no  imperfection 
in  any  of  the  joints  of  that  extremity.  When  this  difficulty  is  perceived,  a  more  cautious 
inspection  of  all  the  joints  of  the  limb  must  be  institutsd,  as  the  probabilities  are  that 
some  defect  exists.    The  elbow  or  wrist  will  generally  be  found  to  be  the  failing  joint. 


22 

peat  it  several  times  ;  run  the  length  of  the  room  in  double 
time  several  times. 

8.  •  Re-examine  the  heart  and  lungs. 

9.  Examine  the  hearing  of  each  ear  separately. 

10.  Examine  the  vision  of  each  eye  separately. 

11.  Test  for  color-blindness. 

AGE  QUALIFICATIONS. 

The  recruit  mimt  not  he  less  than  sixteen  nor  more  than  thirty- 
five  years  of  age. 

The  maximum  age  for  cavalry  recruits  upon  original  en- 
listment is  fixed  at  thirty  years. 

Certain  well-known  and  clearly  marked  physical  charac- 
teristics will  enable  the  recruiting  officer  to  determine  at  a 
glance  whether  or  not  an  applicant  for  enlistment  shall  be 
placed  in  the  broad  mean  as  to  age  between'the  minimum 
and  maximum  fixed  by  law,  although  to  determine  in  an 
individual  either  the  age  of  "majority" — i.  e.,  21  years — or 
the  maximum  age  for  enlistment  is  always  difficult  and 
often  impossible. 

The  desire  to  enter  the  military  service  is  sometimes,  from 
varying  causes,  so  strong  as  to  prompt  certain  youths  or 
middle-aged  men  to  resort  to  any  deceit  for  the  purpose  of 
concealing  the  truth.  Boys  will  announce  themselves  as  of 
age  with  unblushing  eff'rontery,  and  men  who  are  over  the 
maximum  will  add  to  falsehood  the  most  ingenious  artifices 
to  disguise  the  evidences  of  advancing  age. 

The  development  of  the  body  does  not  by  any  means  keep 
pace  with  its  years  of  existence.  Youths  of  18  or  19  years 
occasionally  present  many  physical  characteristics  of  ma- 
turity, while  some  men  pass  the  age  of  thirty-five  without 
showing  well-marked  indications  of  it.  Little  importance 
need  be  attached  to  this  latter  condition,  because  the  maxi- 
mum limit  does  not  apply  to  soldiers  who  re-enlist,  and  dur- 
ing peace  but  few  civilians  present  themselves  after  that  age. 


23 

The  former  condition  is,  however,  an  important  one  and  de- 
mands close  attention. 

Aside  from  the  obvious  objection  to  a  lad  whose  physique 
is  yet  undeveloped,  the  minor  who  enlists  by  deceit  may,  upon 
application  of  his  parent  or  guardian,  be  discharged  from 
the  service  by  the  civil  courts.  As  in  that  case  the  Govern- 
ment sustains  not  only  a  pecuniary  loss  in  the  pay,  clothing, 
food,  etc.,  furnished  him,  but  the  more  important  loss  of  his 
services,  and  as  A.  R.  910  enjoins  upon  the  recruiting  officer 
to  "be  very  particular  to  ascertain  the  true  age  of  the  re- 
cruit," it  becomes  necessary  for  him  to  familiarize  himself 
with  certain  evidences  of  maturity  which  usually  accompany 
the  period  of  legal  majority,  viz  : 

At  twenty-one  years  of  age  the  wdsdom-teeth  are 
usually  cut,  and  on  each  side  of  both  jaws  there  should  be 
found  five  grinders,  viz.,  three  large  double  or  molar  teeth 
and  two  smaller  double  or  bicuspid  teeth.  In  case  of  the 
loss  of  teeth  the  spaces  originally  occupied  by  them  may  be 
seen. 

Under  twenty-one  years  of  age  the  wisdom-teeth  are 
seldom  to  be  found,  and  there  will,  therefore,  be  but  four 
grinders  on  each  side  of  both  jaws,  viz.,  two  molars  and  two 
bicuspids. 

At  maturity  there  should  be  some  beard  upon  the  foce 
and  hair  under  the  arms,  a  full  growth  around  and  above 
the  genital  organs,  and  some  scattered  hairs  in  the  neighbor- 
hood of  the  anus.  The  hair  of  the  body  is  generally  fine 
and  silky. 

After  maturity  the  hair  is  thick  and  coarse  in  the  various 
places  mentioned. 

After  maturity  the  skin  of  the  scrotum  is  somewhat 
darker  in  color  than  the  surrounding  parts,  is  opaque,  and 
is  marked  in  various  directions  by  wrinkles  or  folds. 

Before  maturity  this  skin  retains  the  soft,  velvety  con- 
dition of  youth,  its  pink  or  fresh  flesh  color,  and  is  more  or 
less  translucent,  while  the  wrinkles  or  folds  are  not  well  pro- 


24 

nounced,  or  are  entirely  absent,  particularly  at  the  sides. 
This  condition  of  the  scrotum  is  the  most  valuable  of  the  signs 
ef  maturity. 

Should  a  minor  offer  the  written  consent  of  parent  or 
guardian,  the  question  then  presents  itself  whether  so  young 
a  person  possesses  the  vigor  and  physical  development  neces- 
sary for  the  performance  of  all  the  duties  of  a  soldier. 

Youth,  being  the  period  of  active  growth  for  body  and 
mind,  should  be  passed  under  conditions  that  will  secure  to 
it  the  proper  amount  of  food,  exercise,  and  rest,  in  order  that 
its  growth  may  be  healthy.  These  cannot  always  be  obtained 
in  the  military  service,  the  exigencies  of  which  may  be  such 
as  to  test  to  the  utmost  the  endurance  of  the  soldier  when 
subjected  to  the  hardships  of  extreme  exertion,  inclement 
weather,  loss  of  rest,  and  privation  of  food  incident  to  many 
campaigns.  Under  such  circumstances  the  staying  power  of 
the  immature  youth  is  found  wanting.  His  undeveloped 
body  yields  to  the  strain,  and  a  consequent  permanent  dis- 
ability leads  to  his  discharge  from  the  Army.  As  all  mili- 
tary experience  confirms  this,  and  as  the  opinion  is  almost 
universal  that  youths  are  not  fit  for  the  duty  our  soldiers 
are  called  upon  to  perform,  their  enlistment  should  be  dis- 
couraged save  in  cases  where  their  physical  development  is 
exceptionally  good  and  they  display  a  true  aptitude  for  the 
military  service. 

Although  immature  men  should  never  be  accepted,  it  would 
be  equally  unfortunate  to  enlist  men  who  are  too  old.  On 
moral  grounds  young  men,  who  learn  better  and  more 
quickly,  are  desirable  as  soon  as  they  are  physically  fit. 
The  legal  limit  of  35  is  the  very  extreme  for  recruits  under 
ordinary  circumstances,  and  the  nearer  common  laborers 
approach  that  age  the  more  unlikely  are  they  to  be  accept- 
able. It  has  been  observed  that  for  acceptable  colored  re- 
cruits the  age  of  25  or  26  is  practically  the  maximum,  be- 
cause after  that  they  are  liable  to  be  physically  stiffened  and 
mentalh^   dulled.     Therefore,  as    the    maximum   age    ap- 


25 

preaches,  public  interest  leads  to  the  over  critical  examina- 
tion of  those  who  appear  to  be  getting  into  fixed  physical 
grooves.  ^  - 

HEIGHT,  WEIGHT,  AND  CHEST  MEASUREMENTS. 

"  The  minim  am  height  of  a  recruit  is  at  present  fixed  at 
five  feet  four  inches  for  all  branches  of  the  service,  although 
recruiting  officers  are  allowed  to  exercise  their  discretion  as 
to  the  enlistment  of  desirable  recruits  (such  as  band  musicians, 
school  teachers,  tailors,  etc.)  who  may  fall  not  more  than 
one-fourth  of  an  inch  below  the  minimum  standard  of  height ; 
the  maximum  height  for  the  cavalry  service  is  five  feet  ten 
inches ;  that  for  infantry  and  artillery  is  governed  by  the 
maximum  of  weight,  to  which  should  be  applied  the  rule  for 
proportion  in  height." 

"The  minimum  weight  for  all  recruits  is  128  pounds, 
except  for  the  cavalry,  in  which  enlistments  may  be  made 
without  regard  to  a  minimum  of  weight,  provided  the  chest 
measurement  and  chest  mobility  are  satisfactory.  The  maxi- 
mum for  infantry  and  artillery  is  190  pounds ;  for  cavalry 
and  light  artillery,  165  pounds." 

The' standards  of  height  and  weight  are,  however,  subject 
to  change,  instructions  to  that  effect  being  issued  from  the 
Adjutant  General's  Office  "  from  time  to  time  as  the  require- 
ments of  the  service  may  dictate."     (See  A.  R.  913.) 

These  standards  are  based  upon  results  obtained  by  skilled 
observers  who,  after  careful  study  and  the  examination  of 
large  numbers  of  men  in  civil  and  military  life,  have  estab- 
lished the  fact  that  there  is  an  average  proportion  in  healthy, 
fully  developed  men  between  the  height,  weight,  chest 
measurement,  and  chest  mobility  which  will  admit  of  slight 
variations  without  indicating  a  departure  from  health.  The 
rules  of  this  proportion  may  be  formulated  as  follows : 

For  each  inch  of  height  from  5  feet  4  inches  to  5  feet  7 
inches,  inclusive,  there  should  be  calculated  2  pounds  of 
4 


26 


weight.  When  the  height  exceeds  5  feet  7  inches,  calculate 
2  pounds  of  weight  for  the  wliole  number  of  inches  of  height ; 
add  to  this  product  5  pounds  of  weight  for  each  inch  of 
difference  between  5  feet  7  inches  and  the  actual  height ;  the 
sum  will  be  the  normal  weight  in  pounds. 

The  chest  measurement  at  expiration  in  men  from  5 
feet  4  inches  to  5  feet  7  inches  in  height  should  exceed  the 
half  height  about  J  an  inch  ;  in  those  from  5  feet  8  inches  to 
5  feet  10  inches  it  should  equal  the  half  height,  while  in 
those  from  5  feet  11  inches  upward  it  should  be  slightly  less 
than  the  half  height. 

The  chest  mobility — i.  e.,  the  difference  between  the 
measurement  at  inspiration  and  expiration — should  be  at  least 
2  inches  in  men  below  5  feet  7  inches  in  height,  and  2 J 
inches  in  those  above  that  height. 

The  following  table  shows  this  concisely : 


Height. 

Weight. 

Allow  for  each  inch  of 

height. 

Chest 
Measurement. 

Chest. 
Mobility. 

5  fr.  4  to 

5  ft.  7. 

5  ft.  8  to 

2  lbs 

j  2  lbs.,  and  5  lbs.  ad-  1 
\     ditional    for   each  \ 
1     inch  over  5  ft.  7  in. 

I                                      J 

Half  height  plus  half 
inch. 

Half  height 

2  inches. 
2J  inches. 
2|^  inches. 

5  ft.  10. 
5  ft.  11  to 

Slightly  less  than  half 
height. 

For  example,  a  man  who  measures  5  feet  4  inches  should 
weigh  128  pounds — i.  e.,  5  feet  4  inches  =  64  inches ;  64x  2  = 
128,  the  normal  weight.  He  should  have  a  chest  measurement 
of  321  inches  at  expiration,  being  half  height ;  32  inches  plus 
J  inch  =  32  J ;  the  chest  mobility  should  be  about  2  inches. 

A  man  who  measures  5  feet  9  inches  should  weigh  148 
pounds — i.  6.,  5  feet  9  inches  =  69  inches ;  69x  2  =  138 ;  dif- 
ference between  5  feet  9  inches  and  five  feet  7  inches  is  2 ; 
2  X  5  =  10  ;  138+10  =  148,  the  normal  weight  in  pounds ;  he 


27 

should  have  a  chest  measurement  of  34J-  inches  (his  half 
height)  and  a  chest  mobility  of  at  least  2|  inches. 

It  is  not  necessary  that  the  applicant  should  conform  ex- 
actly to  the  figures  indicated  in  the  rules,  a  variation  of  a 
few  pounds  from  either  side  of  the  standard  in  the  minimum, 
medium,  and  maximum  weights  and  of  a  fraction  of  an  inch 
in  chest  measures  being  permissible  if  the  applicant  is  other- 
wise in  good  health  and  desirable  as  a  recruit.  The  rules 
are  given  to  show  what  is  regarded  as  a  fair  proportion,  hut 
the  weight  must  be  at  least  125  pounds,  except  when  less  is 
especially  authorized  by  the  superintendent  or  the  Adjutant 
General. 

In  such  cases  the  recruiting  officer's  reasons  and  the  super- 
intendent's order  should  be  noted  in  full  on  the  enlistment 
papers.  Any  considerable  disproportion,  however,  of  height 
over  weight  is  cause  for  rejection ;  for  a  marked  dispropor- 
tion of  tueight  over  height  do  not  reject  unless  the  applicant 
is  positively  obese. 

In  order  that  an  intelligent  application  of  these  rules  and 
their  variations  may  be  made,  the  attention  of  recruiting 
officers  is  called  to  the  manner  in  which  a  man's  height  is 
made  up. 

The  chest,  containing  the  heart  and  lungs,  is  the  most  im- 
portant division  of  the  body.  It  contains  the  vital  machinery 
and  represents  the  staying  power  of  the  man.  It  must,  there- 
fore, be  ample.  The  function  of  the  legs  is  to  transport  the 
body;  they  should  be  well  formed  and  sufficient,  but  not 
unduly  long,  for  length  of  limb  at  the  expense  of  the  chest 
is  a  disadvantage.  A  long-legged,  long-necked  man  with  a 
short  chest  is  objectionable  as  a  recruit. 

The  average  height  of  a  youth  of  18  years  of  age,  a  "  grow- 
ing lad,"  is  a  little  over  5  feet  4  inches,  and  increases  gradu- 
ally until  he  reaches  the  age  of  25  years — the  stage  of  physi- 
cal maturity  or  manhood — when  his  average  height  is  be- 
tween 5  feet  7  inches  and  5  feet  8  inches. 

During  the  growing  period   the  frame-work  and  vital 


7 


'M 


28 


organs  receive  their  proper  development,  and  considerable 
departures  from  the  given  average  of  proportionate  height 
to  weight  indicate  an  impairment  of  these  organs  which  may 
and  probably  will  develop  into  positive  disease  after  expos- 
ure to  the  hardships  incident  to  the  life  of  a  soldier ;  hence 
they  are  of  greater  significance  in  men  of  these  heights  than 
in  taller  men,  who  are  presumably  of  greater  age  and  more 
mature  growth. 

After  25  years  of  age,  the  body  being  fully  developed,  the 
excess  of  nutritive  material  over  and  above  that  required 
for  its  maintenance  in  health  is  deposited  in  the  tissues  as 
fat,  and  it  will  be  found  that  a  disproportion  of  weight  over 
height  occurs  usually  in  adults  or  men  in  middle  life.  It  is 
rare  to  meet  in  the  recruiting  rendezvous  with  very  fleshy 
young  men. 

The  following  table  is  given  for  convenience  of  reference  : 

Table  of  Physical  Proportions  for  Height,  Weight,  and  Chei-t  Measurement. 


Height. 

Weight. 

Chest  Measurement. 

Feet. 

Inches. 

Pounds. 

At  Expiration  : 
Inches. 

Mobility  : 
Inches. 

5t*, 

64 

128 

32^ 

2 

Hi 

65 

130 

33 

2 

5t\ 

66 

132 

33i 

2 

^}l 

67 

134 

34 

2 

H, 

68 

141 

34 

2^ 

5t\ 

69 

148 

34^ 

2^ 

^tI 

70 

165 

35 

2^ 

5i 

71 

162 

35i^ 

2^ 

6 

72 

169 

35| 

2^^ 

6iV 

73 

176 

36^ 

2^ 

A  deviation  from  the  rules  of  physical  proportions  may 
be  made  in  the  examination  of  candidates  for  admission  to 
the  U.  S.  Military  Academy  at  AVest  Point,  and  for  members 
of  the  graduating  class,  whenever  this  is  deemed  necessary 
by  the  Medical  Examining  Board. 


29 


THE  SPECIAL  EXAMINATIONS. 

A  careful  examination  of  the  skin  should  be  made,  lirst,  to 
detect  the  presence  of  vermin ;  second,  for  physical  mark- 
ings, as  scars,  moles,  tattooing,  etc. ;  third,  for  any  skin  dis- 
ease. 

The  favorite  haunt  for  vermin  is  in  the  hair  upon  the  head 
and  about  the  genital  organs ;  they  are  also  to  be  found  on 
other  parts  of  the  body.  The  "  nits,"  or  eggs,  may  be  seen  as 
little  black  bodies  attached  to  the  hair,  generally  near  the 
skin. 

Itch  may  be  suspected  if  the  body  presents  evidences  of 
having  been  constantly  scratched,  and  the  spaces  between 
the^ngers  are  the  seat  of  an  eruption. 

These,  together  with  any  skin  eruptions  which  are  mani- 
festly chronic  or  disgusting  in  appearance,  are  causes  for  re- 
jection. Men  infested  with  vermin  should  be  given  an  op- 
portunity to  rid  themselve  of  the  parasites  ;  if  not  success- 
ful in  this  they  should  be  rejected. 

A  crop  of  pimples  on  the  face,  breast,  and  back,  between 
the  shoulders,  is  very  common  in  young  men  and,  being 
entirely  innocent,  should  not  disqualify  a  recruit  otherwise 
desirable. 

MOLES,  BIRTH   STAINS,  SCARS,  AND   TATTOO   MARKS. 

Any  permanent  marking  on  the  body  of  a  recruit  is  worthy 
of  record  as  a  means  of  personal  identification;  hence 
a  careful  and  systematic  search  for  such  marks  should  be 
made,  first  of  one-half  the  body  and  then  of  the  other.  If 
any  are  found  a  descriptive  record  is  to  be  made  on  the 
figure  card  furnished  for  that  purpose  by  the  Adjutant  Gen- 
eral. This  is  to  be  done  by  the  enlisting  officer  only  when 
the  recruit  will  not  subsequently  he  examined  by  a  medical  officer, 
as  in  the  enlistment  of  men  for  the  Signal  Corps,  at  arsenals 
where  there  is  neither  Post  nor  Attending  Surgeon,  etc. 


30 

Moles  are  abnormal  thickenings  or  pigmentations  of  the 
skin,  their  usual  seat  being  the  face,  the  temple,  or  the  ear, 
although  they  may  be  found  on  any  portion  of  the  body. 
They  may  have  the  natural  coloring  of  the  skin,  or  be  red, 
brown  or  black,  and  may  be  either  smooth  or  hairy. 

Birth  Marks  are  of  irregular  outline,  not  necessarily 
raised  above  the  skin,  and  have  the  appearance  of  red,  brown 
or  "  port  wine  "  colored  splashes.  The  smaller  splashes  are 
known  as  ''  strawberry  marks,"  "  cock's  crests,"  etc. 

Scars  are  either  permanent  or  transient.  For  the  purpose 
of  future  identification,  the  former  alone  have  value ;  there- 
fore the  determination  of  their  character  before  making  the 
record  is  of  primary  importance. 

Tattoo  Marks  have  a  certain  value,  but  as  they  may  be 
so  easily  altered  in  design  it  is  not  very  great. 

The  descriptive  record  of  a  permanent  mark  should  be 
very  exact,  its  location  fixed,  first,  on  the  right  or  left  side, 
front  or  rear  of  the  body ;  next,  by  its  proximity  to  or  dis- 
tance in  inches  from  some  well-known  point  of  the  body ; 
next,  by  its  direction  or  inclination,  either  vertical,  horizontal, 
or  oblique ;  next,  by  its  shape,  either  rectilineal,  curved,  oval, 
circular,  undulating,  or  oblong ;  and  if  curved,  which  way  its 
concavity  faces  ;  and,  last,  by  its  dimensions,  when  the  mark 
is  not  too  small  for  ordinary  measurement  or  notice.  In 
describing  marks  on  the  fingers  and  toes,  it  should  be  re- 
membered that  the  phalanges  and  joints  of  both  are  counted 
from  those  nearest  the  hand  or  foot ;  thus  the  joint  connect- 
ing the  finger  with  the  hand  (the  "  knuckle  ")  is  known  as 
the  first  joint,  arid  the  phalanx  forming  part  of  that  joint  is 
known  as  th.Q  first  phalanx.  When  scars  are  quite  small  and 
numerous,  any  principal  one  may  be  described,  and  followed 
by  the  words  "  and  many  others,"  or  the  record  may  stand 
'^  numerous  small  scars."  Tattooing  should  be  particularly 
described  as  to  design,  etc.  When  the  design  is  indecent  or 
obscene  it  is  a  cause  for  rejection,  but  the  applicant  should 
be  given  an  opportunity  to  alter  the  design,  in  which  event 


31 

he  may,  if  otherwise  qualified,  be  accepted.  "  The  impor- 
tance of  particular  marks  as  an  indication  for  identity  is 
directly  in  proportion  to  the  precision  of  their  description," 
which  should  be  made  with  the  idea  that  a  subsequent  ob- 
server may,  by  reading  it,  be  enabled  to  reproduce  on  him- 
self a  tracing  identical  with  the  original  as  to  form,  situation, 
etc.  When  the  record  of  marks  is  completed,  the  color  of 
eyes  and  hair  should  be  taken,  and  as  there  is  a  wide  diver- 
sity in  the  description  of  certain  colors,  a  memorandum  for 
their  record  is  here  given  as  a  guide. 


COLOR  OF   HAIR. 

Between  the  extremes  of  light  flax-colored  and  raven  black 

all  shades  of  brown  are  found.     The  scale  may  be  given  as 

follows : 

Flax-colored. 

Light  brown. 

Dark  brown. 

Black. 
Of  red  hair  as  follows : 

Brick  red. 

Sandy  red. 

Auburn  (reddish  brown). 
Of  grey  hair  as  follows : 

Dark  grey. 

Light  grey,  approaching  white. 

Iron  grey  (mixed). 

COLOR  OF   EYES. 

Observe  first  if  the  color  is  the  same  in  both  eyes ;  then 
note  any  peculiarity  of  pigmentation,  whether  in  the  general 
color  small  black  or  red  spots  are  found.  Note  also  if  there 
is  any  deviation  from  the  normal  circular  form  of  the  iris. 


I 


32 

There  are  but  three  colors  to  be  found  in  the  human  eye — 
viz.,  blue,  brown,  and  black — all  other  shades  being  inter- 
mediate between  these  types.  ^  - 

Of  blue  there  are — 

Light  or  azure  blue. 

Dark  blue.' 

Slate  blue,  erroneously  called  grey. 

Of  brown  there  are — 
Light  brown. 
Dark  brown  (hazel). 

The  black  eye  is  rarely  found  excepting  in  the  negro.  The 
grey  eye  is  a  misnomer  and  should  be  abandoned  for  "  slate 
blue,^'  the  true  color. 

In  time  of  war  exemption  should  be  given  only  on 
account  of  long-standing  or  incurable  diseases  of  the  skin ; 
the  milder  forms,  as  also  some  of  the  parasitic  diseases,  in- 
cluding itch,  may  be  treated  with  reasonable  prospect  of 
recovery  in  a  short  time,  and  the  men  should  accordingly 
be  held  to  service. 

CHRONIC   ULCERS. 

Men  whose  constitutions  have  been  broken  down  by  poverty 
or  vice  are  often  the  subjects  of  ulcerations  of  the  legs,  where 
the  slight  injuries  to  which  so  exposed  a  part  is  liable  have 
failed  to  heal,  or  if  healed  present  large  irregularly  shaped 
scars,  more  or  less  discolored  or  adherent  to  the  bone.  These 
scars,  being  unhealthy,  are  liable  upon  slight  irritation  to  be 
destroyed  and  the  ulcer  reproduced.  Such  men  are  unfitted 
for  soldiers  and  should  be  rejected.  Scars  non-adherent, 
white  and  smooth,  or  even  red,  where  recent,  if  apparantly 
painless  on  manipulation,  resulting  from  an  incised  or 
lacerated  wound  or  a  burn,  not  involving  lesion  of  the  subja- 
cent organs,  are  not  causes  for  rejection. 


33 

In  time  of  war  conscripts  may,  with  a  design  of  evading 
service,  purposely  induce  and  keep  open  ulcers.  Suspicion 
will  naturally  be  aroused  where  a  man,  otherwise  healthy, 
claims  exemption  from  service  on  account  of  an  ulcer  of  long 
standing,  as  this  lesion  is  seldom  seen  except  in  persons  of 
broken-down  constitution  and  generally  in  middle  or  ad- 
vanced age.  The  appearance  of  the  ulcer  and  the  tissues 
surrounding  it  will  furnish  some  evidence  as  to  its  age,  active 
inflammation  pointing  to  voluntary  irritation  and  a  recent 
lesion,  while  an  old  ulcer  presents  characteristics  the  reverse 
of  this.  Such  cases  should  be  placed  under  close  observa- 
tion in  hospital  and  every  means  taken  to  prevent  the  patient 
from  keeping  up  any  irritation  of  the  parts,  bearing  in  mind 
the  fact  that  an  almost  endless  variety  of  foreign  substances 
are  used  for  this  purpose,  and  that  the  finger-nails  are 
especially  convenient  for  such  use.  It  may  become  necessary 
to  place  the  patient  in  confinement  before  a  correct  opinion 
can  be  formed. 

CONSTITUTIONAL  SYPHILIS. 

It  will  be  most  convenient,  while  making  the  general  ex- 
amination of  the  surface  of  the  body,  to  search  for  evidence 
of  constitutional  syphilis,  in  the  detection  of  which  no  single 
sign  will  suffice,  although  the  presence  of  two  or  m,ore  should 
determine  the  matter,  especially  if  the  man  admits  having 
had  a  sore  on  any  part  of  his  penis  or  a  chancre  on  any 
other  part  of  his  body.  It  matters  not  how  small  the  sore 
may  have  been  nor  how  remote  the  time  at  which  it  made 
its  appearance.  One  of  the  earliest  and  most  important  signs 
is  an  enlargement  of  the  glands  (1)  at  the  back  of  the 
neck,  (2)  on  the  inside  of  the  arm  just  above  the  elbow,  and 
(3)  in  the  groins.  The  first  may  be  found  by  grasping  firmly, 
between  the  thumb  and  forefinger,  the  back  of  the  neck  just 
below  the  hair,  and  sliding  the  hand  from  thence  to  the  base 
of  the  neck  ;  if  the  glands  are  enlarged  they  will  be  felt 


34 

under  the  fingers  as  hard  bodies,  slippery  and  movable,  and 
shaped  like  an  ordinary  almond.  (2)  Bend  the  forearm  at 
right  angles  with  the  arm  and  grasp  the  latter  from  behind, 
between  the  thumb  and  forefinger,  just  above  the  elbow,  keep- 
ing the  thumb  on  the  outside,  the  right  hand  being  used 
for  the  examination  of  the  left  arm  and  vice  versa  ;  by  pressing 
deeply  with  the  fingers,  and,  so  to  speak,  rolling  the  flesh  of 
the  arm  under  them,  the  gland,  if  enlarged,  will  be  plainly 
felt,  as  in  the  neck.  (3)  Rub  the  fingers,  with  a  consider- 
able pressure,  over  and  in  the  crease  between  the  abdomen 
and  the  thigh  (groin) ;  the  glands,  if  enlarged,  will  be  felt  as 
in  the  preceding  instances  ;  but  moderately  enlarged  glands 
in  the  groin  are  not  uncommon  and  by  themselves  do  not 
indicate  syphilitic  or  other  generic  disease. 

Syphilitic  eruptions  exist  on  any  part  of  the  skin,  are  of 
a  yellowish-brown  or  copper  color,  generally  circular,  look- 
ing like  stains,  and  are  without  any  pain,  itching,  or  sur- 
rounding redness  ;  they  should  be  looked  for  particularly 
on  the  forehead  and  chest.  Scaly  eruptions  upon  the  palms 
of  the  hands  are  also  indicative  of  this  disease. 

The  hair  thins  out,  or  may  fall  off  in  patches — (alopecia). 

The  nose  and  mouth,  especially  the  latter,  are  the  seat  of 
peculiar  ulcerations.  In  the  nose  they  appear  about  the 
inside  of  the  nostrils ;  in  the  mouth,  on  its  roof,  the  side  of 
the  cheek,  or  on  the  tonsils  and  the  sides  of  the  palate ;  the 
tongue  also  is  often  ulcerated  and  deeply  cracked. 

An  opening  through  the  hard  palate  into  the  floor  of 
the  nose  is  occasionally  made  by  ulceration  and  may  be 
suspected  when  the  applicant  "talks  through  his  nose." 
When  the  head  is  thrown  well  back  and  the  mouth  widely 
opened  this  defect,  otherwise  concealed  by  the  front  teeth, 
may  be  seen. 

The  bones  forming  the  bridge  of  the  nose  are  often  flat- 
tened or  sunken  as  a  result  of  ulcerations  of  the  softer  parts 
underneath. 


35 

The  shin  bones  are  the  seat  of  lumps  (nodes),  easily  felt 
by  running  the  fingers  along  the  edge  of  the  bone.  These 
lumps  are  generally  on  both  shins  and  are  apt  to  be  painful 
at  night.  When  there  is  any  suspicious  sign  elsewhere  the 
shins  should  be  carefully  examined  by  the  touch. 

Warts  and  excrescences  about  the  anus  between  the  but- 
tocks or  on  the  scrotum  (mucous  tubercles  and  vegetations) 
will  be  seen  at  once  by  separating  the  buttocks  wrhile  the  man 
bends  forward.  "  They  appear  as  flat,  slightly-elevated 
papules  about  half  an  inch  in  diameter  and  covered  with 
a  slimy,  fetid  exudation."  They  are  often  ulcerated  and  may 
run  together. 

Scars  from  buboes  are  not  signs  of  constitutional  syphilis. 

It  should  be  borne  in  mind  that  symmetry  in  the  appear- 
ance of  the  external  signs  of  syphilis  is  peculiar  to  the  disease ; 
thus,  one  tonsil  being  sore,  the  other  will  probably  be  sore 
also — a  blotch  on  the  skin  of  one  side  of  the  body  will  prob- 
ably have  its  fellow  on  the  other  side. 

In  time  of  war  syphilis  in  any  of  its  forms  is  cause  for 
rejection. 

THE  HEAD. 

The  scalp  should  be  examined  very  carefully,  by  running 
the  fingers  through  the  hair,  for  depressions  in  the  skull. 
If  any  are  found  that  are  deep  and  abrupt  in  character,  es- 
pecially if  covered  by  a  scar,  the  applicant  should  be  re- 
jected. 

Monstrosity  in  the  size  of  the  head  and  deformity,  the 
consequence  of  fracture,  should  also  reject. 

Baldness  (Alopecia).  If  the  loss  of  hair  is  total,  or  if 
but  a  few  tufts  remain  about  the  back  of  the  head  and  the 
neighborhood  of  the  ears,  or  if  the  scalp  shows  evidence  of 
pre-existing  disease,  the  applicant  should  be  rejected.  Con- 
siderable loss  of  the  hair,  either  over  the  crown  or  above 
the  forehead,  is  cause  for  rejection. 


36 

The  military  head  coverings  are  not  of  themselves  suffi- 
cient protection  against  heat  or  cold ;  there  should  be  enough 
natural  covering  to  the  hairy  scalp  to  provide  against  suffer-^ 
ing  or  disease  from  extremes  of  temperature. 

In  time  of  war  baldness  is  not  cause  for  rejection. 

THE   EARS. 

Tumors  or  growths  in  the  passage  to  the  internal  ear 
may  be  at  once  discovered  and!  are  causes  for  rejection. 

The  discharge  of  "matter"  from  the  ear  is  generally 
an  evidence  of  a  diseased  condition  of  the  parts  within, 
which  is  very  likely  to  lead  to  permanent  deafness,  and  is 
therefore  a  cause  for  rejection. 

Deafness  of  either  ear  constitutes  an  absolute  cause  of 
rejection. 

As  the  distance  at  which  the  natural  tone  of  voice  may 
be  heard  in  a  closed  room,  when  both  ears  are  normal,  is 
about  50  feet,  the  distance  at  which  the  applicant  is  to  stand 
from  the  examiner  must  be  as  great  as  the  apartments  will 
allow,  not  to  exceed  50  feet. 

The  applicant  will  stand  with  his  back  to  the  examiner, 
who  is  to  address  him  in  a  natural  tone  of  voice.  When 
the  distance  is  less  than  40  feet,  it  should  be  specified  on  the 
examination  form,  and  the  tone  of  voice  will  be  lowered.. 
Failure  of  the  applicant  to  respond  to  the  address  of  the 
examiner  will  demonstrate  a  defect. 

The  personal  attention  of  the  recruiting  officer  or  sergeant 
must  be  given  to  closing  the  entrance  to  each  ear  separately, 
by  pressing  with  the  thumb  the  small  lobe  (tragus)  situated 
in  front  of  the  opening  to  the  inner  ear. 

Advantage  should  be  taken  of  the  absence  of  other  sounds 
to  make  the  examination.  Recruiting  officers  should  re- 
member that  a  man  may  be  totally  deaf  in  one  ear,  and  yet 
may  hear  all  ordinary  conversation  perfectly  if  the  sound 
ear  is  not  completely  stopped.     Deafness  of  one  ear  is  a  bar 


37 

to  enlistment,  but  in  ordinary  occupations  it  might  not  be 
observed. 

Deafness  may  be  caused  by  an  accumulation  of  hardened . 

wax ;  therefore  an  otherwise  desirable  recruit  should  have 
his  ears  well  cleansed  before  final  action  is  taken  in  his  case. 

All  men  enlisted  for  the  artillery  arm  of  the  service  at  a 
military  post  or  assigned  to  that  arm  from  a  depot  shall, 
before  such  enlistment  or  assignment,  besides  undergoing 
the  ordinary  examination,  be  examined  especially  with  a 
view  to  establishing  the  fact  of  the  patency  of  the  Eusta- 
chian tubes  and  the  integrity  of  the  tympanic  membranes, 
in  default  of  which  the  men  are  unfit  for  that  arm. 

In  time  of  war  deafness  of  one  ear  is  not  cause  for  rejec- 
tion. It  should  be  borne  in  mind  that  defects  in  hearing  are 
easily  feigned ;  therefore,  when  they  are  alleged  by  con- 
scripts, the  examination  should  be  made  by  a  medical  officer. 
Genuine  deafness  cannot  be  concealed. 

THE    FACE. 

Great  deformities  of  the  face — large,  livid,  hairy,  un- 
sightly spots,  loss  of  substance  of  the  cheeks — are  so  man}^ 
reasons  for  rejection,  as  they  are  calculated  to  excite  aversion 
and  disgust  in  others;  they  may  prove  prejudicial  to  the 
service  by  provoking  discontent  in  the  quarters  and  by  ex- 
posing the  sufferer  to  cruel  and  irritating  sarcasms  and  jests 
that  too  often  end  in  fatal  quarrels. 

THE    EYES. 

The  following  are  causes  for  absolute  rejection : 

Loss  of  either  eye. 

Chronic  inflammation  of  the  lids,  when  they  are  red 
and  swollen,  with  collections  of  more  or  less  dried  matter  on 
the  edges  between  and  around  the  lashes ;  the  ball  of  the  eye 
will  also  be  "  bloodshot." 


38 

Myopia  (near-sightedness). 

Hypermetropia  (over-sigh tedness),  except  when  moderate 
and  free  from  organic  disease. 

Astigmatism. 

Inability  to  read  or  describe  with  facility  the  types 
or  characters  on  the  test  cards.  This  examination  re- 
quires the  greatest  care  and  patience  on  the  part  of  the 
recruiting  officer  ;  it  is  made  with  cards  bearing  the  twenty- 
feet  test-types  and  test-characters. 

To  use  the  cards,  measure  off  a  distance  of  twenty  feet  in 
a  straight  line ;  place  the  applicant  with  his  back  to  the  light 
at  one  end  of  the  line,  while  the  examiner  stands  at  the 
other  and  holds  the  card  exhibiting  the  test  types  or  characters 
in  full  view  of  the  applicant  and  so  that  a  good  light  falls 
on  the  card.  Each  eye  should  be  examined  separately,  one 
being  covered  with  a  card  (not  with  the  hand)  by  an  assistant, 
who,  standing  behind  the  applicant,  directs  him  to  read  the 
types  on  the  card  held  by  the  examiner ;  if  he  cannot  read, 
the  card  bearing  the  characters  is  presented  to  him,  which 
he  is  directed  to  describe.  The  types  should  be  read  first 
from  left  to  right  and  then  from  right  to  left ;  the  characters 
should  be  described  as  to  the  number  of  arms  seen  on  each 
and  the  direction  in  which  they  are  pointed,  whether  up- 
ward or  downward,  to  the  right  or  left. 

If  the  applicant  should  be  unable  to  read  the  test-types  or 
describe  the  test-characters  correctly  with  either  eye,  he  must 
be  rejected. 

This  standard  for  vision  may  be  departed  from  in  the  ex- 
amination of  candidates  for  appointment  into  the  Medical 
Corps  of  the  Army  and  in  the  enlistment  of  members  of  the 
Hospital  Corps,  and  applicants  accepted  who  are  the  subjects 
of  refractive  errors,  viz.,  myopia,  hypermetropia,  presbyopia, 
and  astigmatism,  provided  these  errors  are  not  excessive, 
may  be  entirely  corrected  by  glasses,  and  are  not  progressive 
or  accompanied  by  ocular  disease. 

The  object  of  this  test  is  to  exclude  from  the  service  men 


39 

whose  visual  defects  are  such  as  to  prevent  them  from  be- 
coming marksmen.  Successful  use  by  the  soldier  of  long- 
range  fire-arms  demands  that  his  vision  shall  be  normal  or 
so  nearly  normal  that  there  need  be  no  question  of  his 
ability  to  see  the  target  at  all  ordinary  ranges. 

A  large  percentage  of  men  are  the  subjects  of  slight  visual 
defects,  not  to  such  an  extent  as  to  disqualify  them  for  mili- 
tary duty,  but  sufficient  to  cause  a  little  blurring  or  indis- 
tinctness in  some  of  the  letters  of  the  required  test,  which 
may  be  increased  by  the  nervous  apprehension  of  failure. 
Ignorance,  stupidity,  or  fear  on  the  part  of  an  applicant  are 
factors  to  be  considered  in  making  this  examination,  and 
unless  the  recruiting  officer  exercises  sound  judgment  he  will 
probably  reject  men  whose  vision  is  in  reality  good ;  hence 
plenty  of  time  should  be  taken  and  slight  errors,  such  as 
misreading  a  P  or  T  for  an  F,  provided  the  majority  of  the 
letters  or  test  characters  are  read  with  facility,  need  not  be 
regarded  as  a  failure  of  the  test. 

Prominence  of  the  eyeballs  to  such  an  extent  as  to  pre- 
vent the  lids  from  closing — (exophthalmos) ; 

Drooping  of  the  upper  lids  over  the  eyeballs,  with  in- 
ability to  raise  them — (ptosis) ; 
Adhesion  of  the  lids  to  the  eyeballs ; 
Scalding  of  the  cheeks  from  tears,  indicating  closure  of 
the  tear-duct ; 

Cross-eye  or  squint  of  the  right  eye,  if  permanent  or  well 
marked  (strabismus),  are  all  subjects  for  disqualification. 

Double  vision,  or  that  condition  of  sight  in  which  two 
images  instead  of  one  are  seen  when  the  applicant  is  re- 
quired to  look  steadily  at  an  object — (diplopia). 

The  following  defects,  if  discovered,  should  be  noted  on 
the  enlistment  papers  of  the  recruit  by  the  recruiting  officer, 
and  the  question  of  rejection  left  to  the  decision  of  the  sur- 
geon at  the  depot : 

A  film  across  the  white  of  the  eye,  pyramidal  in 
shape,  the  apex  resting  on  or  near  the  "sight"  (ptery-- 
gium). 


40 

Milky  opacities  on  the  cornea  (leucoma). 

Wavering  and  divergence,  generally  outward,  of  one 
or  both  eyes  when  the  applicant  is  required  to  look  steadily  _ 
at  an  object,  say  the  hand  or  fingers,  held  at  a  distance  of  six 
or  eight  inches  from  the  face  (asthenopia). 

A  rotary  or  oscillating  movement  of  one  or  both  eyes 
when  looking  at  an  object  at  the  ordinary  visual  distance 
(nystagmus) ;  both  eyes  are  generally  affected,  and  the 
nervous  character  of  the  disease  is  shown  by  the  increased 
motion  during  the  examination. 

In  time  of  war  none  of  the  defects  mentioned  above  as 
disqualifying  in  time  of  peace  should  exempt  conscripts  from 
service,  save  those  caused  b}^  extreme  refractive  errors  or 
organic  diseases ;  and  as  defects  of  vision  are  easily  feigned, 
the  examination  of  the  vision  in  doubtful  cases  should  be 
made  by  a  medical  officer. 

THE   NOSE. 

Loss  of  the  nose  disqualifies  the  recruit,  not  only  because 
it  may  be  the  indication  of  a  constitutional  disease  but  be- 
cause the  consequent  modification  of  voice  renders  speech 
unintelligible. 

Ill  smelling  discharge  from  the  nose,  either  through  the 
nostril  or  the  mouth,  or  ver}"  offensive  breath,  which  is  in- 
dicative of  a  chronic  disease  called  "  ozoena,"  demands  the 
rejection  of  the  subject.  Chronic  catarrh  of  the  nose  which 
may  temporarily  occlude  the  nostrils,  or  permanent  closure 
of  the  nostril  from  any  cause,  and  tumors  inside  the  nose 
(polypi)  are  causes  for  rejection.  The  examining  officer 
must,  however,  be  careful  not  to  mistake  slight  irregularities 
in  the  septum  (which  are  not  uncommon)  for  a  polypus. 

In  time  of  war  loss  or  unsightly  deformities  of  the  nose 
and  ozoena  are  causes  for  rejection. 


41 


THE  MOUTH. 


The  following  defects  of  these  parts  are  disqualifications  : 

Hare  lip— simple,  compound,  or  complicated. 

Loss  of  the  whole  or  part  of  either  lip. 

Unsightly  mutilation  of  the  lips  from  wounds, 
burns,  or  disease. 

Loss  of  the  whole  or  part  of  either  jaw-bone. 

Deformities  of  either  jaw-bone  interfering  with 
mastication  or  speech. 

Inability  to  open  the  jaws  widely. 

Enlargement  or  shrinkage  of  the  tongue. 

Mutilation  or  the  partial  or  total  loss  of  the  tongue. 

Growth  of  the  tongue  to  the  sides  of  the  mouth. 

Stammering  or  stuttering,  if  at  all  considerable. 

A  growth  of  the  cheeks  to  the  sides  of  the  jaws, 
impeding  their  free  motion. 

Fissures  of  the  hard  palate. 

Perforation  of  the  hard  palate,  an  occasional  sequel  of 
syphilis,  is  objectionable  on  account  of  the  modification 
produced  by  it  in  the  voice  and  the  fact  that  through  the 
perforation,  fluids  are  allowed  to  pass  into  the  nose  from  the 
mouth. 

Chronic  enlargement  of  the  tonsils  sufficient  to  im- 
pede swallowing  or  speech. — To  obtain  a  good  view  of 
the  tonsils  and  back  parts  of  the  mouth  and  throat  the  re- 
cruit should  open  his  mouth  as  widely  as  possible  and  pro- 
nounce the  word  "Ah  !  h-h  "  in  a  prolonged  breath.  The 
arches  of  the  palate  and  the  soft  palate  will  by  this  ma- 
noeuvre be  raised  and  an  unobstructed  view  of  the  parts 
obtained. 

Loss  of  voice,  or  a  manifest  alteration  of  it. 

An  inability  to  pucker  the  mouth  as  in  whistling  is 
an  indication  of  paralysis  of  the  face,  which  should  reject. 

Loss  of  teeth. — The  condition  of  the  teeth  is  to  be  con- 
6 


42 

sidered  solely  with  reference  to  the  proper  mastication  of 
food.  If  there  are  not  enough  in  the  mouth  for  this  purpose 
food  is  swallowed  without  the  necessary  preparation,  and 
indigestion  with  imperfect  nutrition  and  its  consequent 
evils  are  the  result.  If  several  of  the  teeth  are  decayed,  es- 
pecially about  the  crown,  it  is  probable  that  before  the  ex- 
piration of  an  enlistment  they  will  be  so  far  destroyed  as  to 
render  mastication  imperfect ;  hence  men  who  have  lost  the 
front  teeth  from  decay  and  have  many  unsound  back  teeth 
should  be  rejected.  The  loss  of  the  front  teeth  through  ac- 
cident is  not  cause  for  rejection,  provided  a  sufficient  num- 
ber of  the  back  teeth  are  sound. 

Unless  an  applicant  has  at  least  four  sound  double  teeth, 
one  above  and  one  below  on  each  side  of  the  mouth,  and 
so  opposed  as  to  serve  the  purpose  of  mastication,  he  should 
be  rejected.  Exception  may  be  made  by  the  Adjutant  Gen- 
eral in  the  case  of  a  soldier  who  desires  to  re-enlist,  if  a  re- 
port is  made  showing  his  age,  physical  condition  as  to 
nutrition,  and  the  number  an(^  location  of  the  sound  teeth. 

If  the  front  teeth  remain  and  the  double  teeth  are  gone 
rejection  is  demanded. 

If  the  loss  of  the  natural  teeth  is  supplied  by  artificial 
ones  the  fact  should  be  noted  on  the  enlistment  papers,  but 
the  artificial  substitutes  cannot  be  considered  as  equivalent 
in  value  to  the  natural  teeth  or  as  removing  the  disability 
on  this  account  for  military  service. 

In  time  of  war  simple  hare  lip,  scars,  enlarged  tonsils, 
and  loss  of  teeth  are  not  causes  for  rejection. 

THE   NECK. 

Goitre,  a  tumor  situated  at  the  base  of  and  across  the 
neck,  just  below  "Adam's  apple,"  if  large  enough  to  inter- 
fere with  breathing  or  the  hooking  of  the  collar  of  the  coat, 
or  if  recent  or  growing. 


43 

The  violet-colored  adherent  sears  of  scrofulous 
ulcerations  in  this  region  are  causes  for  rejection. 

Openings  in  the  wind-pipe,  or  "Adam's  apple,"  should 
also  reject. 

In  time  of  war  goitre,  unless  excessive,  is  not  cause  for 
rejection. 

THE   CHEST. 

The  chest  should  be  ample. 

The  circumference  of  the  chest  is  measured  by  passing 
the  tape  around  it  immediately  at  the  point  of  the  shoulder 
blade,  the  arms  hanging  down.  Generally  the  tape  will 
then  be  found  to  fall  below  the  nipple. 

In  taking  this  measure  contortions  of  the  body,  such  as 
bending  backward  to  '''throw  out"  the  chest  or  bending 
forward  to  "  draw  it  in,"  should  be  avoided. 

The  applicant  should  stand  erect  without  muscular  strain 
or  rigidity.  After  the  tape  is  placed  in  position  and  lies 
snugly  and  evenly  upon  the  skin  and  while  the  loose  ends 
are  held  between  the  fingers  of  the  examiner  so  that  when 
the  chest  is  expanded  the  tape  will  run  readily  through 
them,  the  applicant  should  be  directed  to  draw  in  slowly  and 
steadily  a  long  breath  until  his  chest  is  inflated  to  its  utmost 
capacity,  when  the  record  of  chest  circumference  at  inspiration 
should  be  read  from  the  tape.  He  is  then  to  expel  the  air 
by  counting  slowly  and  steadily  from  one  onward  until  he  can 
no  longer  resist  the  urgent  demand  for  inspiration,  when 
the  record  of  chest  circumference  at  expiration  should  be  read. 
This  should  be  repeated  several  times  to  insure  accuracy. 
Many  men  are  extremely  awkward  in  developing  their  chest 
capacity  on  demand  and  great  care  and  patience  are  neces- 
sary^ in  getting  the  true  measurements. 

A  man  whose  chest  measures  less  than  32  inches  in  circum- 
ference at  expiration  should  be  rejected,  unless  he  be  consid- 
ered specially  desirable,  when  the  case  may  be  reported  to 
higher  authority. 


44 

The  applicant  should  be  carefully  questioned  as  to  his 
history  and  that  of  his  family.  If  he  admits  having  had 
severe  and  long-continued  cough  and  night  sweats  and 
states  that  he  has  lost  any  members  of  his  family  from  con- 
sumption, he  should  be  rejected.  So  if  he  is  under  weight, 
with  a  flat  chest,  or  is  "  chicken-breasted,"  because  in  these 
latter  cases  the  chest  is  "  seldom  strong  enough  or  roomy 
enough  to  permit  the  lungs  to  have  free  play  in  them."  In 
both  examples  the  risk  of  acceptance  is  too  great. 

When  the  chest  is  narrow  and  elongated,  the  countenance 
pale,  or  with  merely  a  brilliant  point  upon .  the  cheeks,  the 
voice  husky,  or  articulation  short,  quick,  interrupted  almost 
every  moment  for  want  of  breath,  the  skin  presenting  a  fine- 
ness of  texture,  a  whiteness  or  straw-colored  tint,  with  ab- 
normal dryness — when  the  limbs,  more  or  less  long,  are 
thin,  furnished  with  soft  and  emaciated  muscles — the  indi- 
vidual is  absolutely  unfit  for  a  soldier's  life. 

It  is  sufficient  to  require  rejection  that  the  chest  should 
be  ill-formed;  that  its  structure  should  appear  to  be  too 
weak,  and  that  the  other  parts  of  the  organism  should  be 
stamped  with  signs  ''  of  debility  and  suffering." 

It  is  true  we  run  the  risk  of  rejecting  men  who  inay  after- 
wards become  very  robust  and  who,  by  a  long  and  success- 
ful life,  may  contradict  the  opinion  we  may  have  pro- 
nounced in  their  cases ;  but  the  Army  is  not  a  public  sani- 
tarium, and  "one  willbe  astonished  at  the  number  of  men 
who,  received  because  no  determinate  lesion  of  the  chest  was 
recognized  when  they  were  inspected,  succumb  afterward 
with  consumption,  or  whom  it  was  necessary  to  send  back 
to  their  families  with  broken  health  after  their  strength  had 
been  exhausted.  This  is  the  plague  of  the  army.  I  have 
already  said  that  a  feeble  man  left  at  home  may  become 
strong ;  but  send  him  into  the  ranks  and  he  perishes  almost 
certainly.  Betwixt  these  two  rocks  neither  the  physician, 
the  officer,  nor  the  magistrate  can  hesitate  an  instant." 

Bleeding  from  the  lungs ; 


45 

Badly  united  fractures  of  the  ribs,  leaving  a  sharp 
angle  at  the  point  of  injury  ; 

"Wheezy  "  breathing  (asthma)  are  all  causes  for  rejec* 
tion. 

THE   HEART. 

The  only  lesion  of  this  organ  discoverable  by  a  non-pro- 
fessional man  is  enlargement  (hypertrophy),  which  may  be 
suspected  by  a  marked  deviation  of  the  "  apex  beat "  of  the 
heart  from  its  proper  place,  about  two  inches  below  the  left 
nipple  and  about  one  inch  to  its  right,  between  the  fifth  and 
sixth  ribs. 

It  is  not  always  easy  to  see  the  impulse  of  the  heart  against 
the  chest  walls,  and  the  recruiting  officer  must  therefore /e^^ 
for  it.  By  placing  the  ends  of  two  fingers  in  the  interspace  of 
the  ribs  just  below  the  nipple  and  pressing  baqkward  with 
some  force  it  can  be  felt,  even  in  very  fat  men  or  in  those 
whose  lung  tissue  may  accidentally  cover  it  thickly. 

The  deviation  in  enlargement  is  generally  downward  and 
to  the  left,  and  when  to  the  extent  of  about  two  inches  from 
the  normal  point,  if  accompanied  by  powerful  action,  disease 
may  be  suspected  and  the  applicant  rejected. 

There  are  two  conditions  likely  to  mislead,  viz.,  extreme 
"  nervousness  "  from  fright  or  embarrassment  and  an  irreg- 
ular action  caused  by  the  excessive  use  of  tobacco  or  coffee, 
or  both.  The  hurried,  sharply  accentuated  action  of  the 
heart  in  the  former  and  its  irregular  action  in  the  latter  case 
can  hardly,  with  the  exercise  of  due  care,  be  mistaken  for  the 
powerful  rythmical  action  in  enlargement,  in  which  condi- 
tion the  blood  vessels  of  the  head  and  neck  will  often  be 
found  distended  and  beating  with  considerable  violence. 
The  pulse  at  the  wrist  should  also  be  felt,  and  any  intermis- 
sion or  dropping  of  beats  should  lead  to  rejection. 

In  time  of  war  all  organic  diseases  of  the  heart  or  lungs 
are  causes  for  rejection. 


46 


THE   ABDOMEN. 


There  are  three  easily  recognized  forms  of  rupture  (her- 
nia), viz.,  inguinal,  scrotal,  and  umbilical,  any  of  which  is  a 
cause  for  rejection.  They  may  be  discovered  by  requiring 
the  applicant  to  extend  his  arms  above  his  head  and  to 
cough.  If  there  is  a  rupture  at  any  of  these  points  the 
bowel  will  protrude  through  the  opening  and  present  to  the 
view  of  the  observer  a  "  bunch  "  or  tumor.  If  the  hand  is 
now  placed  or^  this  tumor  and  the  applicant  again  required 
to  cough,  a  distinct  shock  or  impulse  will  be  felt  in  the 
tumor,  which  will  appear  to  swell  and  become  tense.  Steady 
pressure  will  in  most  cases  cause  the  bowel  to  recede  into 
the  abdomen  with  a  peculiar  slip  or.  gurgle,  which  is  char- 
acteristic. This  can  be  recognized  more  easily  when  the 
man  is  made  to  lie  down. 

The  seat  of  an  inguinal  hernia  is  in  or  above  the  crease 
between  the  abdomen  and  the  thigh  ;  of  a  scrotal  hernia,  in 
the  scrotum  above  the  testicle ;  of  an  umbilical  hernia,  at 
the  "  navel."  This  latter  must  not  be  confounded  with  a 
simple  "pouting  navel,"  from  which  it  may  be  distin- 
guished by  its  doughy,,  inelastic  consistence  and  by  the  ab- 
sence of  an  impulse  on  coughing. 

There  may  be  found  in  some  men  a  condition  of  the  parts 
through  which  the  bowel  would  pass  in  the  formation  of  a  her- 
nia that  is  known  as  "  relaxed  abdominal  rings,"  and  is  con- 
sidered by  some  surgeons  as  indicating  a  "  tendency  to  hernia." 
There  is,  however,  no  special  evidence  to  show  that  hernia 
follows  this  condition  with  greater  frequency  than  it  does 
when  the  parts  are  normal.  To  exclude  this  class  of  cases 
would  cause  the  loss  to  the  sarvice  of  many  excellent  men, 
and  it  should  not,  therefore,  be  considered  a  cause  for  rejec- 
tion ;  but  in  cases  of  suspected  hernia  or  "  incomplete  her- 
nia "  the  recruiting  officer  should  reject  an  applicant,  unless 


47 

a  Medical  Officer  pronounces  the  man  to  be  free  from  the 
defect. 

Fistula  in  Ano  and  Hemorrhoids  (piles)  may  be  dis- 
covered by  requiring  the  applicant  to  turn  his  back  to  the 
light,  stoop  well  forward,  and  with  both  hands  separate  the 
buttocks  widely.  This  exposes  the  anus.  A  fistula  may  be 
suspected  if  at  the  verge  of  the  anus,  or  at  any  point  within 
a  radius  of  an  inch  thereof,  a  pimple  is  seen,  in  the  centre  of 
which  is  "proud flesh;  "  and  suspicion  becomes  almost  cer- 
tainty if  the  man  admits  having  had  at  any  time  a  "  boil " 
in  that  locality.  Under  these  circumstances  he  should  be 
rejected. 

Hemorrhoids  (piles)  are  of  two  kinds,  internal  or  bleed- 
ing and  external.  The  recruiting  officer  cannot  discover 
the  former,  but  may  suspect  their  existence  if  there  is  a  dis- 
charge of  matter  or  blood  from  the  anus.  If  the  applicant 
admits  that  he  is  the  subject  of  this  form  of  the  disease  he 
should  be  rejected. 

External  piles  appear  as  tumors  or  loose  flabby  folds  of 
skin  about  the  verge  of  the  anus,  and  may  be  recent  or  old. 
If  recent  they  will  appear  about  the  size  of  a  buck-shot,  of  a 
bluish  color,  hard  and  tense  to  the  feel,  and  their  covering 
will  look  thin.  If  old  they  -will  probably  be  as  large  as  a 
marble,  of  a  brawny  feel,  reddish-brown  color,  and  have  a 
thick  covering..  If  recent,  as  above  described,  they  are  not 
cause  for  rejection,  neither  are  they  if  old  and  single  and  the 
applicant  asserts  that  they  have  never  been  painful  or  trou- 
blesome ;  but  if  there  should  be  more  than  one  old  pile  and 
they  are  larger  than  described,  or  if  a  single  old  pile  is  ulcer- 
ated or  inflamed,  or  if  there  is  a  small  pile  associated  ivith 
varicose  veins  of  the  legs,  the  applicant  should  be  rejected. 
The  flabby  folds  of  skin  are  not  cause  for  rejection  unless 
very  large. 

If  the  applicant  is  accepted  any  blemish,  no  matter  how 
slight,  about  this  region  should  be  noted  on  his  enlistment 
papers. 


48 

In  time  of  war  hemorrhoids,  external  or  internal,  unless 
excessive,  and  hernise,  unless  they  cannot  be  retained  in 
place  by  a  truss,  are  not  causes  for  rejection.  Other  defects 
which  disqualify  in  peace  do  so  also  in  war. 

THE   GENITAL   AND    URINARY  ORGANS. 

Any  acute  and  all  venereal  diseases  of  these  organs 
are  causes  for  rejection. 

A  sore  upon  the  head  of  the  penis,  in  the  furrow  imme- 
diately behind  it,  or  on  the  foreskin  is  in  the  vast  majority 
of  instances  venereal ;  and  while  it  is  well  known  that  there 
are  two  kinds  of  venereal  sores,  one  (chancroid)  innocent,  so 
far  as  its  effects  upon  the  general  system  are  concerned,  and 
the  other  (chancre)  virulent,  infective  of  the  system,  it  is 
equally  well  known  that  it  is  not  always  possible  to  dis- 
tinguish the  one  from  the  other ;  hence  one  may  find  that  a 
so-called  "  innocent "  sore  is  followed  in  due  time  by  con- 
stitutional symptoms,  or  a  supposed  virulent  sore  is  free 
from  such  results.  This  being  the  fact,  the  Government  is 
entitled  to  the  benefit  of  the  doubt,  and  these  cases  should 
be  rejected.  The  same  remarks  apply  to  gonorrhoea.  No 
physician  can  say  positively  that  an  attack  of  this  disease, 
however  mild,  will  not  be  followed  by  a  stricture  of  the 
urethra.  It  is  the  experience  of  the  writer  that  stricture  is 
far  more  frequently  a  sequence  of  gonorrhoea  than  even  pro- 
fessional men  generally  admit,  for  which  reason  all  cases  of 
this  disease  should  be  rejected.  Other  acute  diseases,  such 
as  swelled  testicle,  simple  inflammation  of  the  foreskin  and 
head  of  penis  (balanitis),  etc.,  may  or  may  not  b3  of  venereal 
origin ;  but  it  is  safer  to  reject  the  man  than  to  accept  him 
and  afterwards  have  him  rejected  at  the  second  examina- 
tion or  discharged  the  service  at  a  subsequent  date. 

Loss  of  the  penis  is  a  cause  of  rejection. 

Phimosis,  "  an  elongation  of  the  foreskin,  with  contrac- 
tion of  its  orifice  or  adhesion  of  the  foreskin  to  the  glands, 


49 

preventing  the  foreskin  from  being  drawn  back  so  as  to  ex- 
pose the  head  of  the  penis,"  is  cause  for  rejection. 

This  condition,  although  apparently  trivial,  is  occasion- 
ally the  cause  of  serious  disorder  of  the  nervous  system,  as 
epilepsy,  paralysis,  etc.  It  interferes  with  the  free  discharge 
of  urine  and  prevents  a  thorough  cleansing  of  the  parts 
from  the  natural  secretions,  which  when  retained  act  as  an 
irritant,  setting  up  inflammation  and  unfitting  the  soldier 
for  the  performance  of  duty. 

Warts  are  not  unfrequently  found  upon  the  penis.  Their 
location  is  generally  in  the  furrow,  although  they  may  be 
situated  anywhere  about  the  head  and  foreskin.  As  a, rule 
they  are  innocent  in  character,  are  produced  by  uncleanli- 
ness,  and  are  not  a  cause  for  rejection. 

Epi-  and  Hypospadia. — The  urethra  occasionally  termi- 
nates by  an  opening  in  the  course  of  the  penis  either  on 
the  upper  (epispadia)  or  under  (hypospadia)  surface.  When 
this  opening  is  further  from  the  free  end  of  the  penis  than 
one-fourth  the  length  of  the  organ,  reject. 

Stricture  of  the  urethra  can  be  detected  only  from  the 
confession  of  the  man  himself.  If  upon  being  questioned 
he  admits  an  attack  of  gonorrhoea,  and  that  he  passes  a 
stream  of  water  which  is  crooked  or  twisted,  or  if  at  the  close 
of  the  act  the  water  dribbles  from  him,  falling  between  his 
feet,  or  if  the  stream  is  small  and  passed  with  difficulty, 
there  is  good  reason  to  suspect  a  stricture,  and  the  applicant 
should  be  rejected. 

Loss  of  both  testicles  by  extirpation  or  disease  or  marked 
dwindling  (atrophy)  of  both  or  special  sensitiveness  of  either 
rejects. 

The  absence  of  both  testicles  from  their  natural  situation 
does  not  necessarily  imply  the  loss  of  them  from  either  of 
these  causes,  for  they  may  never  have  descended  into  the  scrotum. 
If  the  organs  have  been  extirpated  by  accident  or  design  the 
scar  of  the  wound  will  reveal  the  fact ;  if  they  have  disap- 
peared from  atrophy  some  rudiment  will  still  remain  to  show 
7 


50 

that  they  have  descended.  If  neither  of  these  signs  be 
present  and  the  testicles  are  not  in  the  scrotum  they  are 
either  still  in  the  abdomen  or  are  arrested  in  the  groin, - 
where  they  ma}^  be  felt  and  possibly  seen  as  tumors  or 
lumps  and  may  be  distinguished  by  the  peculiarly  sicken- 
ing pain  felt  when  they  are  vigorously  squeezed  between 
the  fingers.  If  tliey  occupy  any  portion  of  the  groin  they 
incapacitate  the  man  from  their  liability  to  be  followed  by 
rupture,  and  particularly  from  their  exposure  to  painful  in- 
jury and  to  strangulation ;  but  if  they  are  within  the  abdo- 
men and  the  man  appears  vigorous  otherwise  the  condition 
may  be  disregarded.  These  remarks  are  also  applicable  to 
those  cases  in  which  only  one  testicle  is  present  in  the 
scrotum. 

If  three  testicles  are  supposed  to  be  in  the  scrotum  the 
applicant  may  be  accepted,  and  the  fact  noted  on  his  enlist- 
ment paper,  the  case  being  left  to  the  decision  of  the  sur- 
geon at  the  depot  whether  the  extra  body  is  a  testicle  or 
not. 

Any  great  enlargement  of  the  testicle,  especially  if  the 
organ  is  very  hard  and  insensitive,  is  indicative  of  serious 
disease,  and  should  be  cause  for  rejection. 

Caution  is  necessary  in  examining  the  testicle  that  the 
"  epididymis "  is  not  confused  with  some  morbid  growth. 
This  body  lies  upon  the  upper  and  b^^ck  part  of  the  testicle 
and  may  occasionally  feel  hard  or  swollen,  as  a  result  of 
some  former  inflammation.  Indeed  it  may,  under  some 
circumstances,  be  taken  for  a  varicocele.  There  is  no  dis- 
ease to  which  it  is  subject,  discoverable  by  a  non-professional 
man,  that  would  be  cause  for  rejection. 

Accumulation  of  fluid  in  the  scrotum  (hydrocele)  may 
be  discovered  by  the  distention  of  the  parts  and  by  the  sen- 
sation of  fluctuation  given  to  the  fingers  by  the  contained 
fluid.  It  sometimes  simulates  the  appearance  of  a  scrotal 
hernia.     It  is  a  cause  for  rejection. 

There  may  also  be  an  accumulation  of  fluid  in  the  sper- 


51 

matic  cord  (hydrocele  of  the  cord),  giving  rise  to  a  tumor  situ- 
ated above  the  testicle,  between  it  and  the  groin,  into  which 
it  often  extends.     This  is  cause  for  rejection.  ~ 

Varicocele  is  an  enlargement  of  the  veins  leading  from 
the  testicle,  which  have  "  a  peculiar  knotted  and  convoluted 
feel,  and  the  sensation  conveyed  to  the  hand  is  often  com- 
pared to  that  which  would  be  given  by  a  bunch  of  earth- 
worms." 

When  slight  this  is  not  a  cause  for  rejection ;  but  it  is 
presented  to  the  examiner  in  so  many  degrees  of  develop- 
ment— from  an  almost  imperceptible  enlargement  of  a  few 
of  the  veins  to  a  condition  in  which  all  of  them  are  swollen 
as  large  as  goose  quills  and  completely  fill,  by  their  mass, 
the  scrotum — that  the  determination  of  the  cases  would  be 
most  perplexing,  even  to  a  medical  expert,  but  for  the  rule 
formulated  by  Tripler,  which,  if  strictly  followed,  will  ex- 
clude from  the  service  men  thus  physically  unfitted. 

This  rule  is  as  follows :  "  If  the  testicle  upon  that  side  is 
atrophied  (shrunken),  whatever  may  be  the  volume  of  the 
cirsocele  (varicocele),  or  if  the  volume  of  the  latter  exceeds 
that  of  the  former,  the  recruit  should  be  rejected  " — that  is, 
the  varicocele  should  not  be  greater  in  bulk  than  the  sound 
testicle. 

A  good  position  in  which  to  obtain  the  best  view  of  the 
scrotum  is  to  require  the  applicant  to  advance  one  leg,  carry 
the  other  as  far  back  as  possible,  and  then  bend  the  advanced 
leg  at  the  knee.  The  presence  of  varicocele  can,  however,  be 
determined  only  by  handling  the  parts. 

Incontinence  of  urine  may  be  suspected  if  the  person 
or  clothing  of  the  applicant  exhales  a  urinous  odor  or  his 
clothing  gives  other  evidence  of  having  been  saturated  with 
urine,  and  is  cause  for  rejection. 

In  time  of  war  none  of  the  above-mentioned  defects  are 
causes  for  rejection,  unless  they  are  of  sufficient  extent  to 
interfere  with  locomotion.  Acute  venereal  diseases  may  be 
treated  in  hospital. 


52 


THE    BACK. 


Curvature  of  the  spine,  with  round  shoulders.  To  de- 
tect curvature  of  the  spine  draw  an  imaginary  line  from  the 
centre  of  the  base  of  the  skull  to  the  end  of  the  spine.  If 
it  passes  one  inch  either  side  of  the  spinal  prominences  reject. 
(Parker.) 

Arching  of  the  back,  with  flattening  of  the  front  part 
of  the  chest,  are  disqualifications  when  they  exist  to  such  a 
degree  as  to  impede  respiration  or  to  interfere  with  the  ac- 
tion of  the  heart,  as  also  is  wry-neck,  an  affection  in  which 
the  head,  twisted  to  one  side,  cannot  be  brought  back  to  its 
natural  position. 

The  recruiting  officer  cannot,  of  course,  discover  whether 
these  blemishes  interfere  with  the  functions  of  the  lungs  or 
heart,  but  he  can  see  if  they  are  very  much  pronounced  and 
reject;  or  if  he  is  in  doubt  note  the  facts  on  the  enlist- 
ment papers  and  let  the  surgeon  at  the  depot  decide  the  ques- 
tion. 

Men  frequently  present  themselves  for  inspection  with 
shoulders  of  unequal  height.  This  is  generally  the  result  of 
habit  and  of  no  consequence,  unless  connected  with  true 
curvature  of  the  spine.  The  degree  of  this  curvature,  where 
it  exists,  will  determine  the  eligibility  of  the  recruit ;  but, 
particularly  in  peace,  recruits  with  rounded  or  unsymmet- 
rical  shoulders  are  not  desirable,  although  they  may  be  ac- 
cepted. Whenever  shoulders  of  unequal  height  are  seen 
attention  should,  of  course,  be  directed  to  the  spinal  col- 
umn. 

AFFECTIONS  OF  THE   EXTREMITIES. 

It  is  a  matter  of  primary  importance  that  the  soldier 
should  have  the  perfect  use  of  all  his  limbs,  and  that  the 
completeness  and  integrity  of  these  organs  should  be  in  no- 
wise impaired.  Careful  inspection  of  the  limbs,  even  to  the 
most  minute  detail,  will  therefore  not  be  neglected  by  the 


53 

officer  who  feels  a  proper  interest  in  the  pjood  of  the  service 
or  in  his  own  reputation. 

Many  of  the  lesions  and  deformities  of  the  limbs  that 
disqualify  a  recruit  are  common-  to  both  the  upper  and 
lower  extremities.  Others  are  peculiar  to  the  one  or  the 
other. 

The  COMMON  LESIONS  are  chronic  rheumatism,  with 
swelling  and  stiffness  of  the  joints  or  the  neighboring  tissues, 
causing  any  impediment  to  the  performance  of  the  normal 
motions  ; 

Wasting  of  a  limb  from  any  cause  ; 

Old  dislocations,  if  attended  by  any  impairment  of  mo- 
tion or  distortion  of  the  joint. 

The  shoulder,  elbow,  and  wrist  joints  are  the  most  com- 
mon sites  for  these  injuries. 

The  applicant  for  enlistment  will,  of  course,  put  the  best 
face  on  the  results  of  these  cases  and  stoutly  assert  that  the 
joint  is  as  good  as  ever;  but  he  should  in  all  cases  be  tried 
with  a  rifle,  to  see  if  he  can  perform  quickly  and  easily  the 
various  motions  required  in  the  manual  of  arms  and  in  the 
"  set-up "  drill.  Even  if  motion  is  perfect  it  is  doubtful 
policy  to  enlist  a  man  who  has  any  amount  of  distortion 
from  a  dislocated  joint,  because  he  has  enough  of  a  visible 
defect  upon  w^hich  at  any  time  to  hang  an  excuse  for  a  dis- 
charge if  from  any  cause  the  service  becomes  irksome  to 
him.  Fortunately  badly  damaged  joints  are  easily  dis- 
covered, and  the  safest  plan  in  such  cases  is  to  reject,  even 
if  the  distortion  or  loss  of  motion  be  ever  so  slight. 

The  same  general  remarks  will  apply  to  important  frac- 
tures, especially  if  they  have  been  in  the  neighborhood  of 
joints.  If  followed  by  wasting  of  the  limb  or  paralysis 
there  can  be  no  doubt  about  the  necessity  for  rejection. 

Severe  sprains ; 

Voluntary  or  involuntary  dislocation  of  joints ; 

Defective  or  excessive  curvature  of  the  limbs  ; 

Complete  or  partial  stiffness  of  any  joint ; 


54 

Extensive,  deep,  or  adherent  scars,  where  they  in- 
terfere with  the  motion  of  a  limb  ; 

Loss  of  a  limb,  or  an  essential  part  thereof; 

Contractions  or  permanent  flexions  of  a  limb  or  a 
portion  thereof  are  all  causes  for  rejection. 

In  time  of  war  the  defects  above  mentioned  are,  with 
the  exception  of  sprains,  causes  for  rejection,  but  many  of 
them  are  so  easily  feigned  that  when  alleged  by  a  recruit  or 
conscript  the  examination  should  be  made  by  a  medical 
officer. 

SPECIAL  LESIONS   OF  THE    UPPER  EXTREMITIES. 

Fractures  of  the  collar-bone  where  there  is  much  de- 
formity or  if  the  seat  of  the  fracture  is  near  the  outer  ex- 
tremity of  the  bone. 

The  fingers  adherent  or  united. 

Permanent  flexion  or  extension  of  one  or  more  fin- 
gers, as  well  as  irremediable  loss  of  motion  of  these 
parts. 

Total  loss  of  either  thumb. 

Mutilation  of  either  thumb  to  such  an  extent  as  to 
produce  material  loss  of  flexion  or  strength  of  the  member. 
The  common  distortion  of  the  extremity  due  to  contusion 
or  felon  need  not  disqualify. 

Special  care  should  be  used  in  the  examination  of  the 
thumbs  with  a  view  to  the  ability  of  the  applicant  to  use 
them  in  cocking  the  rifle,  for  which  purpose  a  rifle  should 
be  kept  at  the  rendezvous. 

Total  loss  of  the  index  finger  of  the  right  hand. 

Loss  of  the  second  and  third  joints  of  all  of  the 
fingers  of  the  right  hand. 

The  joints  of  fingers  and  toes  are  counted  from  those  nearest 
the  hand  or  foot. 

Total  loss  of  any  two  fingers  of  the  same  hand. 

Mutilation  of  the  last  joints  of  all  the  fingers  of 
either  hand. 


55 

All  these  defects  constitute  absolute  causes  for  exclusion 
from  the  military  service. 

We  frequently  meet  with  permanent  partial  flexion  of  the 
little  finger  of  one  or  both  hands,  due  to  the  effect  of  some 
particular  varieties  of  labor.  These  flexions  do  not  dis- 
qualify, as  they  in  nowise  interfere  with  the  prompt  and 
effective  handling  of  arms.  The  permanent  flexion  of  any 
other  finger  does,  and  should  exclude  from  service. 

Redundant  fingers  are  not  always  objections  to  a  recruit. 
If  the  redundant  finger  is  upon  the  outer  border  of  the  hand 
it  is  not  usually  in  the  way,  and  particularly  if  it  be  the  left 
hand.  We  think,  unless  this  appendage  were  more  devel- 
oped than  we  have  ever  seen  it,  we  should  not  regard  it  in 
the  inspection  of  a  recruit. 

In  time  of  war  the  loss  of  the  right  thumb ;  loss  of  any 
two  fingers  of  the  same  hand ;  loss  of  the  second  and  third 
phalanges  of  the  fingers  on  the  right  hand  ;  permanent 
flexion  or  extension  of  two  fingers  of  the  right  hand,  or  all 
the  fingers  united  (webbed),  are  causes  for  exemption. 

SPECIAL  LESIONS  OF  THE   INFERIOR   EXTREMITIES. 

Varicose  veins— i.  e.,  swollen  or  enlarged  veins. 

In  young  men,  the  development  of  varicose  veins  to  a  de- 
gree of  prominence  that  would  warrant  especial  attention  is 
rarely  met  with;  it  is  more  commonly  found  in  men  of 
thirty  years  and  upward,  particularly  in  those  of  intem- 
perate habits  or  of  feeble  constitution.  Mechanical  obstruc- 
tion to  the  flow  of  blood  through  the  veins  may  also  be  the 
cause.  Moderate  prominence  of  the  veins  in  men  who  are 
otherwise  healthy,  and  who  are  temperate,  ne9d  not  dis- 
qualify. 

But  it  must  be  borne  in  mind  that  the  tendency  of  this 
affection  is  to  become  aggravated,  particularly  in  tall  men, 
and  upon  long  marches  with  knapsacks  and  arms. 


56 

The  character,  then,  of  the  veins  should  be  well  noted. 
Sometimes  the  minute  superficial  branches  only  are  enlarged. 
This  is  particularly  the  case  in  the  space  behind  the  knee 
and  on  the  inside  of  the  thigh  and  is  in  itself  of  no  conse- 
quence, but  when  clusters  of  knots  are  seen,  or  one  or  more 
single  knots,  large  and  with  thin  walls,  or  a  net-work  of 
enlarged  branches  are  found  about  the  ankle,  the  back  of 
the  foot,  the  calf  of  the  leg,  the  ham  or  thigh,  or  distinctly 
enlarged  veins  exist,  that  are  not  necessarily  knotted, 
especially  if  extending  above  the  knee,  the  man  should  be 
rejected.  In  all  cases  when  there  is  chronic  tumefaction, 
dropsy  of  the  limbs,  or  marks  of  ulceration,  rejection  is 
demanded. 

A  soft  swelling,  having  the  appearance  of  a  varicose  vein, 
is  frequently  found  on  the  outside  of  the  leg,  caused  by  a 
lack  of  development  in  the  covering  of  the  muscles  (fascia), 
allowing  a  small  portion  to  protrude ;  this  is  harmless  and 
should  not  be  mistaken  for  a  varicose  vein. 

Lameness,  perceptible  limping,  to  whatever  cause  it  may 
be  due,  demands  the  rejection  of  a  recruit. 

Knock-knees. 

This  deformity  sometimes,  though  rarely,  exists  to  such  a 
degree  as  to  unfit  a  man  for  military  service.  When  dis- 
qualifying it  is  impossible  for  the  man  to  take  the  position 
of  a  soldier  and  he  is  mechanically  disabled  from  perform- 
ing a  long  march.  We  would  say,  generally,  that  if  a  re- 
cruit cannot  bring  the  inner  borders  of  the  feet,  from  the 
heel  to  the  ball  of  the  great  toe,  within  one  inch  of  each  other 
without  passing  the  inner  surface  of  the  knees  respectively 
in  front  of  and  behind  each  other  he  is  unfit  for  service. 

Loose  cartilages  in  the  knee-joint  are  liable  to  slip  from 
their  ordinary  situation  when  sudden  and  violent  exertion 
is  made  and  to  be  caught  and  pinched  between  the  bones 
forming  the  joint ;  motion  is  impossible ;  the  most  exquisite 
pain  is  produced  and  the  sufferer  will  probably  faint.     The 


57 

presence  of  these  bodies  cannot  be  determined  by  any  physi- 
cal examination,  but  applicants  should  be  questioned  as  to 
the  matter  and  rejected  if  there  is  reason  to  believe  them  the 
subjects  of  this  defect. 
'    Club-feet  are  always  positive  disqualifications. 

Splay-feet. 

The  foot  that  renders  a  man  unfit  for  service  is  that  in 
which  the  arch  is  so  far  effaced  that  the  entire  inner  border 
of  the  foot  rests  upon  the  ground ;  the  inner  ankle  is  very 
prominent,  as  is  also  the  bone  of  the  foot  articulating  with  it, 
and  the  axis  of  the  leg  does  not  fall  upon  the  centre  of  the 
foot — giving  the  effect  that  the  ankle-joint  has  been  dislocated 
and  the  foot  crushed  down  and  outward.  This  extreme 
degree  of  splay  or  fiat  foot  is  not  often  seen ;  a  broad  and 
flat  sole  is  common  to  the  laboring  classes  and  particularly 
so  among  negroes,  but,  unless  an  ill-fitting  shoe  is  worn,  this 
shape  of  the  foot  is  not  more  likely  to  induce  disability  in 
long  marches  than  is  the  arched  foot  of  a  more  shapely 
mould. 

All  the  toes  joined  together. 

The  great  toe  crossing  the  other  toes,  with  great 
prominence  of  the  second  joint  of  the  great  toe  (bunion). 

Over-riding  or  super-position  of  any  or  all  the  toes 
to  a  degree  that  renders  the  wearing  of  a  shoe  painful ;  the 
ordinary  overlap  of  the  fleshy  part  of  the  second  toe  upon 
the  great  and  third  toes  is  not  a  cause  for  rejection. 

Loss  of  a  great  toe. 

Loss  of  any  two  toes  from  the  same  foot. 

Permanent  flexion  of  the  last  joint  of  one  of  the  toes 
(hammer  toe)  so  that  the  free  border  of  the  nail  bears  upon 
the  ground,  or  flexions  at  a  right  angle  of  the  last  joint  of  a 
toe  (usually  the  second  toe)  upon  the  second,  with  stiffness 
of  the  joint. 

Ingrowing  nail  of  the  great  toe,  usually  upon  the  outer 
side,  if  deep  and  accompanied  with  signs  of  inflammation  or 
ulceration. 
8 


58 

Corns  on  the  sole  of  the  foot,  especially  if  situated  on 
the  under  side  of  the  "  ball  "  or  base  of  the  great  toe. 
Stinking  feet. 

These  are  all  causes  for  the  rejection  of  a  recruit  and  are 
too  frequently  neglected. 

They  invariably  cause  lamaness  upon  a  march  and  often 
disqualify  a  man  from  undergoing  the  drills  necessary  for 
his  instruction. 

When  a  man  walks  upon  the  nail  of  the  toe,  "  hammer 
toe,"  as  it  is  termed,  during  a  march,  sand  and  other  foreign 
bodies  find  their  way  between  the  nail  and  the  skin,  produc- 
ing severe  pain  and  irritation,  and  even  if  this  is  escaped 
the  constant  pressure  upon  the  free  border  of  the  nail  is  felt 
throughout  its  whole  surface  of  adhesion,  and  develops  there, 
and  sometimes  in  the  root  of  the  nail,  insupportable  pain 
and  inflammation.  In  the  case  of  stiff  joints  the  constant 
friction  of  the  shoe  upon  a  march  soon  obliges  the  man  to 
give  up  and  take  to  the  wagons.  Men  with  such  infirmities 
are  of  no  use  whatever  as  soldiers. 


For  the  benefit  of  Medical  Officers  the  following  table  of 
disqualifications  for  service  in  the  Army  of  the  United 
States  is  given : 

Mental  Infirmities. 

Insanity,  Idiocy,  Imbecility,  Dementia. 

Moral  Infirmities. 

Intemperance  in  the  use  of  Stimulants  or  Narcotics,  Conviction  of  Felony, 
Masturbation,  Sodomy. 

Cerebro-Spinal  System. 

Epilepsy,  Chorea,  all  forms  of  Paralysis,  Tabes  Dorsalis,  Neuralgia, 
Stuttering. 

General  Disqualifications. 

Feebleness  of  Constitution  (poor  physique),  Scrofulous  Diathesis,  Can- 
cerous Diathesis,  Syphilis. 


59 


Special  Disqualifications. 

The  Skin. — All  chronic,  contagious,  and  parasitic  diseases  of  the  skin  j- 
nsevi ;  extensive,  deep,  and  adherent  cicatrices ;  chronic  ulcers,  vermin. 

The  Head. — Abnormally  large  head  ;  considerable  deformities,  the  con- 
sequence of  fractures;  serious  lesions  of  the  skull,  the  consequence  of  com- 
plicated wounds  or  the  operation  of  trephining ;  caries  and  exfoliation  of 
the  bone,  injuries  of  cranial  nerves,  tinea  capitis,  alopecia. 

The  Spine. — Caries,  spina  bifida,  lateral  curvature  of  the  cervical,  dorsal, 
or  lumbar  regions  ;  lumbar  abscess,  rickets,  fracture  and  dislocation  of  the 
vertebrae,  angular  curvatures,  including  gibbosity  of  the  anterior  and  pos- 
terior parts  of  the  thorax. 

The  Ears. — Deafness  of  one  or  both  ears,  all  catarrhal  and  purulent 
forms  of  acute  and  chronic  otitis  media,  polypi  and  other  growths  or  dis- 
eases of  the  tympanum,  labyrinth,  or  mastoid  cells  ;  perforation  of  the  tym- 
panum ;  closure  of  the  auditory  canal,  partial  or  complete,  except  from 
acute  abscess  or  furuncle ;  malformation  or  loss  of  the  external  ear  and  all 
aiseases  thereof,  except  those  which  are  slight  and  non-progressive. 

The  Eyes. — Loss  of  an  eye,  total  loss  of  sight  of  either  eye ;  conjunctival 
affections,  including  trachoma,  entropion  ;  opacities  of  the  cornea,  if  cover- 
ing part  of  a  .moderately  dilated  pupil ;  pterygium,  if  extensive ;  strabis- 
mus, hydrophthalmia,  exophthalmia,  conical  cornea,  cataract,  loss  of  crys- 
talline lens,  diseases  of  the  lachr3'mal  apparatus,  ectropion,  ptosis,  incessant 
spasmodic  motion  of  the  lids,  adhesion  of  the  lids,  large  encysted  tumors, 
abscess  of  the  orbits,  muscular  asthenopia,  nystagmus. 

Any  affection  of  the  globe  of  the  eye  or  its  contents  ;  defective  vision, 
including  anomalies  of  accommodati6n  and  refraction  ;  myopia ;  hyper- 
metropia,  if  accompanied  by  asthenopia;  presbyopia,  astigmatism,  ambly- 
opia, glaucoma,  diplopia,  color-blindness  (for  the  Signal  Service  only). 

The  Face. — Nsevi,  unsightly  hairy  spots,  extensive  cicatrices  on  the  face. 

The  Mouth  and  Fauces. — Hare-lip,  simple,  double,  or  complicated  ;  loss 
of  the  whole  or  a  considerable  part  of  either  lip  ;  unsightly  mutilation  of 
the  lips  from  wounds,  burns,  or  disease  ;  loss  of  the  whole  or  part  of  either 
maxilla,  ununited  fractures,  ankylosis,  deformities  of  either  jaw  interfering 
with  mastication  or  spoech,  loss  of  certain  teeth,  cancerous  or  erectile  tu- 
mors, hypertrophy  or  atrophy  of  the  tongue,  mutilation  of  the  tongue,  ad- 
hesion of  the  tongue  to  any  parts,  preventing  its  free  motion ;  malignant 
diseases  of  the  tongue,  chronic  ulcerations,  fissures  or  perforations  of  the 
hard  palate,  salivary  or  bucco-nasal  fistuiae,  hypertrophy  of  the  tonsils 
sufiicient  to  interfere  with  respiration  or  phonation. 

The  Neck. — Goitre,  ulcerations  of  the  cervical  glands,  cicatrices  of  scrof- 
ulous ulcerations,  tracheal  openings,  wry-neck,  chronic  laryngitis,  any  or 
other  disease  of  the  larynx  which  would  produce  aphonia,  stricture  of  the 
aesophagus. 


60 

The  Chest. — Malformation  of  the  chest,  or  badly  united  fractures  of  ribs 
or  sternum  sufficient  to  interfere  with  respiration;  caries  or  necrosis  of  ribs, 
deficient  expansive  mobility,  evident  predisposition  to  phthisis,  phthisis 
pulmonalis,  chronic  pneumonia,  emphysema,  chronic  pleurisy,  pleural"" 
effusions,  chronic  bronchitis,  asthma,  organic  disease  of  the  heart  or  large 
arteries,  serious  and  protracted  functional  derangement  of  the  heart,  dropsy 
dependent  upon  a  disease  of  the  heart. 

The  Abdomen. — All  chronic  inflammations  of  the  gastro-intestinal  tract, 
including  diarrhoea  and  dysentery  ;  diseases  of  the  liver  or  spleen,  including 
those  caused  by  malarial  poisoning  ;  ascites,  obesity,  dyspepsia,  if  con- 
firmed ;  hcemorrhoids,  prolapsus  ani,  fistula  in  ano,  considerable  fissures  of 
the  anus,  hernia  in  all  situations. 

The  Genito-Urinary  Organs. — Any  acute  affection  of  the  genital  organs, 
including  gonorrhoea  and  venereal  sores  ;  loss  of  the  penis,  phimosis,  strict- 
ure of  the  urethra,  loss  of  both  testicles,  permanent  retraction  of  one  or  both 
testicles  within  the  external  ring,  any  chronic  disease  of  the  testicle,  hydro- 
cele of  the  tunic  and  cord,  atrophy  of  the  testicle,  varicocele,  malformations 
of  the  genitalia,  incontinence  of  urine,  urinary  fistula?,  enlargement  of  the 
prostate,  stone  in  the  bladder,  chronic  cystitis,  all  diseases  of  the  kidney. 

Affections  Common  to  both  Upper  and  Lower  Extremities. — Chronic 
rheumatism,  chronic  diseases  of  joints,  old  or  irreducible  dislocations  or  false 
joints,  severe  sprains,  relaxation  of  the  ligaments  or  capsules  of  joints,  dis- 
locations, fistulae  connected  with  joints,  or  any  part  of  bones  ;  dropsy  of 
joints,  badly  united  fractures,  defective  or  excessive  curvature  of  long  bones, 
rickets,  caries,  necrosis,  exostosis,  atrophy  or  paralysis  of  a  limb;  extensive, 
deep,  or  adherent  cicatrices  ;  contraction  or  permanent  retraction  of  a  limb 
or  portion  thereof,  loss  of  a  limb  or  portion  thereof. 

The  Superior  Extremities. — Fracture  of  the  clavicle,  fracture  of  the  radius 
and  ulna,  webbed  fingers,  permanent  flexion  or  extension  of  one  or  more 
fingers,  as  well  as  irremediable  loss  of  motion  of  these  parts  ;  total  loss  of 
either  thumb,  mutilation  of  either  thumb,  total  loss  of  the  index-finger  of 
the  right  hand,  loss  of  the  second  and  third  phalanges  of  all  the  fingers  of 
either  hand,  total  loss  of  any  two  fingers  of  the  same  hand. 

The  Lower  Extremities. — Varicose  veins,  knock-knees,  club-feet,  splay 
or  flat  feet,  webbed  toes,  the  toes  double  or  branching,  the  great  toe  crossing 
the  other  toes,  bunions,  corns,  overriding  or  superposition  of  any  of  the 
toes  to  an  extreme  degree,  loss  of  a  great  toe,  loss  of  any  two  toes  of  the 
same  foot,  permanent  retraction  of  the  last  phalanx  of  any  of  the  toes,  or 
flexion  at  a  right  angle  of  the  first  phalanx  of  a  toe  upon  the  second,  with 
ankylosis  of  the  articulation  ;  ingrowing  of  the  nail  of  the  great  toe,  stink- 
ing feet. 


INDEX. 


A. 

Page. 

Abdomen,  the 46 

Abdominal  rings,  relaxed 46 

Adam's  apple,  openings  into 43 

Age  qualifications 22-25 

limit 7 

previous  service  as  affecting 7 

Alopecia,  see  Baldness. 

Anus,  examination  of_.-L 20 

in  syphilis 35 

Apex  beat  of  the  heart 45 

Artificial  teeth 42 

Artillery,  height  and  weight  for 25 

Artillery  men,  special  examination  of  hearing  of 87 

Artisans,  skilled,  need  not  have  knowledge  of  the  English  language.  13 

may  be  under  height 25 

Asthma 45 

Astigmatism 38 


B. 

Back,  the ^ 52 

arching  of  the 52 

Balanitis 48 

Baldness  (alopecia) 35 

Band  musicians  need  not  speak  English 13 

may  be  under  height 25 

Beard,  growth  of,  in  minors 23 

Birth-marks 29,  30 

Bubo,  significance  of '. 35 

Bunions 57 

C. 

Cadets,  military,  West  Point,  rule  of  physical  proportions  for 23 

Candidates  for  admission  to  the  hospital  corps,  vision  test  for 38 

medical  corps,  vision  test  for 38 

(61) 


62 

Page. 

Cartilages,  loose,  of  the  knee-joint 56 

Catarrh,  chronic  nasal 40 

Cavalry,  age  limit 22 

height  and  weight  for 25 

Chancre 48 

Chancroid 48 

Characteristics,  physical,  of  recruit 11 

Character,  evidence  of,  required 7 

Cheeks 41 

Chest,  defects  in ^ 44,  45 

measurements,  the 26 

how  to  take  them ^ 43 

measure,  raohility,  &c.,  rule  of  proportions  for 26,27 

tahle  of  proportions  for 28 

methods  of  examining  the 43-45 

mobility 26 

Chicken-breasted 44 

Chronic  enlargement  of  the  tonsils 41 

nasal  catarrh 40 

rheumatism 53 

ulcers 32 

Cleanliness,  reasons  for 14 

Clubfeet 57 

Collar  bone,  fracture  of 54 

Color  of  eyes 31,  32 

hair 31 

"Competent  knowledge  "  of  the  English  language 12 

Completion  of  enlistment  papers , 7 

Constitutional  syphilis 33 

Consumption,  indications  of 44 

Cord,  spermatic,  fluid  in 51 

Cornea,  opacity  of 40 

Corns 58 

Corps,  hospital,  vision  test  for  members  of  the 38 

medical,  vision  test  for  candidates  for  the 38 

Criminals,  enlistment  of,  prohibited 8 

Cross-eyes 39 

Curvature  of  the  spine 52 

I>. 

Deafness 36,  37 

Debility- 11,44 

Defects  of  all  degrees  to  be  noted 16 


63 

Page. 

Degree  of  knowledge  of  English,  how  recorded 15 

Deserter,  enlistment  of,  prohibited 8 

Discharge  from  ears 36 

nose 40 

Dislocations 53 

Disposition  of  examination  form ^  16 

Disqualifications,  table  of 58-60 

Drunkards,  physical  characteristics  of __. 1'2 

E. 

Ears 36,37 

tumors  of 36 

•    discharge  from 36 

deafness 86 

English  language,,  competent  knowledge  of 12 

degree  of  knowledge  of,  how  recorded 15 

skilled  artisans  need  not  have  knowledge  of 13 

Enlargement  of  the  glands  (syphilitic) 83 

tonsils 41 

Enlistment,  general  requirements  for 8-10 

oath  of  (Art.  of  War  2) 8 

of  recruit?,  responsibility  for 10 

papers,  completion  of 7 

prohibitions  to  (Art.  of  War  3) 8 

Epididymis,  the 50 

Epispadia 49 

Eruptions,  syphilitic - 34 

Evidence  of  character  required 7 

Evidences  of  maturity 23,  24 

Examination,  form  for 17-19 

how  disposed  of , 16 

the  general 11-13 

order  of 20-22 

special 29 

Examining  a  recruit,  mode  of 14 

Extremities,  affections  of 52-54 

Eyeball,  prominence  of 39 

Eyelids,  adherent 39 

drooping 39 

inflammation  of 37 

Eye,  loss  of  either 37 

Eyes,  color  of 31, 32 

the 37-40 


64 
F. 

Page. 

Face,  deformities  of 37 

Far-sight  (hypormetropia) 38" 

Feebleness,  general 11,44 

Feet,  club 57 

offensive 58 

splay 57 

Felons,  enlistment  of,  prohibited 8 

Figure  and  general  appearance,  how  noted 16 

Fingers,  defects  of  the 64,  55 

Fistula  in  ano 47 

Form  for  examination 17-19 

disposition  of 16 

uses  for 15 

Fractures ^  53 

of  the  collar  bone 54 

of  the  ribs 45 

G. 

General  examination 11-13 

requirements  for  enlistment 8-10 

Genital  and  urinary  organs 48-51 

Glands,  enlarged  in  syphilis 38 

Gleet 49 

Goitre 42 

Gonorrhoea —        48 

H. 

Habits  of  intemperance,  indications  of 12 

Hair,  color  of 31 

in  syphilis 34 

growth  of,  in  minors. 23 

Hammer  toe 58 

Harelip 41 

Head,  the  defects  of 35,36 

Hearing,  defects  in,  see  Deafness. 

of  artillery  men  to  be  specially  examined 37 

Heart,  apex  beat  of 45 

hypertrophy  of 45 

the 45 

Height,  weight,  and  chest  measurements 25-28 

rule  of  proportions  for 26 

special  exceptions  in 25 

table  of  proportions  for 28 


65 

Page. 

Hemorrhoids  (piles) 47 

external 47 

internal 47 

Hernia,  incomplete 46 

inguinal 46 

scrotal 46 

tendency  to 46 

umbilical 46 

Hospital  corps,  vision  test  for  members  of 38 

Hydrocele 50 

of  the  cord 51 

Hypospadia 49 

I. 

Incontinence  of  urine 51 

Infantrj',  height  and  weight  for 25 

Inferior  extremities,  special  lesions  of 55,58 

Ingrowing  toe  nail 57 

Insane,  enlistment  of,  prohibited 8 

Intemperance,  indications  of  habits  of 12 

Intellectual  requirements 9 

Intoxicated  person,  enlistment  of,  prohibited 8, 11 

Itch 29 

J. 

Jaw,  deformities  of 41 

loss  of 41 

stiffness  of 41 

Joints,  stiffness  of ^ . .. 53 

K. 

Knee-joint,  loose  cartilage  in 56 

Knock  knees 56 

Knowledge,  competent,  of  the  English  language 12 

Language,  English,  competent  knowledge  of 12 

Lameness 1 56 

Legal  requirements,  the 7-lQ 

Legs,  cicatrices  on 54 

Light  artillery,  maximum  weight  for 25 

9 


m 

Page. 

Limbs,  loss  of 54 

permanent  flexions  of , 54 

tobemobile 52, 

shape  of,  changed ^ 53 

wasting  of 53 

Limit  of  age 7 

Lip,  hare 41 

mutilation  of 41 

Loose  cartilages  of  the  knee-joint 56 

Loss  of  teeth 41,  42 

Loss  of  voice 41 

Lungs,  bleeding  from 44 


M. 

Marks,  birth 30 

tattoo 30 

Maturity,  evidences  of 23,24 

Measurements,  chest,  how  to  make  them 43 

height,  weight,  and  chest 25-28 

rule  of  proportions  for 26 

special  exceptions  in 25 

table  of  proportions  for 28 

Medical  corps,  vision  test  for  candidates  for  admission  to  the__ 38 

Military  cadets,  West  Point,  rule  of  physical  proportions  for 28 

Minors,  consent  required  for 8 

enlistment  of,  prohibited 8 

physical  development  of . 27,28 

Mobility  of  chest 26 

Mode  of  examining  a  recruit .__  14 

Moles 29,30 

Moral  requirements 10 

Mouth,  the 41,42 

in  syphilis 34 

Musicians,  band,  need  not  speak  English 13 

Myopia,  see  Near-sight. 

^• 

Nail,  too,  walking  on  the 58 

ingrowing 67 

Nasal  catarrh,  chronic 40 

polypus 40 

Near-sightedness  (myopia) 88 


67 

Page. 

Neck,  the._ 42,43 

scars  of ^48 — 

Nose,  the 40 

discharge  from 40 

loss  of 40 

in  syphilis 34 


O. 

Oath  of  enlistment  (Art.  of  War  2) 8 

Opacity  of  cornea 40 

Order  of  examination 20-22 

Ozcena 40 


P. 

Palate,  hard,  fissure  of 41 

perforation  of 34,41 

Penis,  affections  of 48,  49 

.     loss  of 48 

Phimosis 48 

Physical  proportions,  rule  of 25 

for  military  cadets,  West  Point 28 

tableof 28 

Piles,  see  Hemorrhoids. 

Pimples 29 

Polypus,  nasal 40 

Previous  service,  as  affecting  age 7 

Probation,  recruits  on 7 

Proportions,  physical,  rule  of 25 

for  military  cadets 28 

tableof 28 

Pterygium 39 

Ptosis 39 

Q. 
Qualifications,  age 22-25 

K. 

Recruit,  mode  of  examining 14 

on  probation 7 

responsibility  for  enlistment  of 10 


68 

Page. 

Re-enlistments,  age  in 7 

physical  requirements  for 13,  It 

Re-examination  at  rendezvous 16 

Relaxed  abdominal  rings 46 

Requirements  for  enlistment,  general 8-10 

the  legal 7-10 

Responsibility  for  enlistment  of  recruits 10 

Rheumatism,  chronic 53 

Ribs,  badly  united  fractures  of 45 

Rule  of  physical  proportions  for  height,  weight,  &c. 25 

for  military  cadets-  28 

Rupture 46 

■  S. 

Scalp,  the 35 

Scars 29,30,43 

non-adherent 32 

and  marks,  description  of 00,31 

School  teachers  may  be  under  height 25 

Scrotum,  fluid  in 50 

skin  of,  in  minors 23 

Service,  previous,  as  affecting  age 7 

Skin,  the - —  29 

eruptions 1 29 

of  the  scrotum  in  minors 23 

Shins,  the,  in  syphilis 35 

Skull,  depressions  in 35 

Special  examinations 29 

Spine,  curvature  of  the '. 52 

Splay  feet ^ 57 

Sprains 53 

Squint 39 

Stammering 41 

Strabismus 39 

Stricture  of  urethra 49 

Syphilis,  constitutional,  signs  of . .-  33 

T. 

Table  of  disqualifications 58-60 

physical  proportions  for  height,  weight,  &c 28 

Tailors  need  not  speak  English 13 

may  be  under  height 25 

Tattoo  marks 29,  30 


69 

Page. 

Teeth,  artificial 42 

development  of,  in  minors 23_ 

loss  of 41,  42 

Test  of  vision 38 

Testicles,  affections  of 49,  50 

atrophy  of 49 

enlargement  of 50 

loss  of 49 

supernumerary 50 

undescended 49 

Thorax,  see  Chest. 

Thumbs,  defects  of 54 

Toes,  defects  of  the .^ 57 

hammer 58 

ingrowing  nail  of  the 57 

walking  on  the  nail  of  the 58 

Tongue,  alterations  in 41 

Tonsils,  chronic  enlargement  of 41 

Tubercles,  mucous  (syphilitic) 35 

U. 

Ulcers,  chronic 32 

Upper  extremities,  affections  of  the 54,55 

Urethra,  abnormal  openings  in 49 

stricture  of 49 

Urinary  and  genital  organs 48-51 

Urine,  incontinence  of 51 

Uses  for  examination  form 15 


V. 

Varicocele 51 

Varicose  veins 55,  56 

Vegetations,  syphilitic 35 

Venereal  diseases 48 

Vermin,  personal 29 

Vision,  double 89 

test 38 

object  of 39 

for  candidates  for  admission  to  the  medical  corps 38 

for  members  of  the  hospital  corps 38 

Voice,  alteration  of 41 

loss  of 41 


70 
w. 

Page. 

Warts,  syphilitic ^ 36 

venereal,  but  not  syphilitic 49 

Weight,  height,  and  chest  measurement,  the 25-28 

rule  of  proportions  for 26 

special  exceptions  in 25 

table  of  proportions  for 28 

West  Point,  rule  of  physical  proportions  for  military  cadets  at 28 

Wheezing  (asthma) 45 

Windpipe,  openings  into 43 

Wisdom  teeth,  as  evidence  of  maturitv —  23 


TTbra:^ 


^^^mmti'T^aim 


